Q&A: My three year-old son gets ear infections every fall and spring. Does he need to get ear tubes? -T. in Georgia
Thanks, T. Constantly battling with ear infections can take a toll on you as well as your child. We place tubes usually for two separate reasons: #1 fluid behind the eardrum that does not clear up in 2-3 months after an infection. While fluid is there, hearing may be reduced significantly enough to cause speech delay or impediment, or poor school benhavior. And #2: recurrent ear infections, 3 in 6 months or 4 in 12 months. Basically it may be safer to have a minor procedure than suffer through all the misery of painful ear infections and expose your child to so much antibiotics. Kids generally do grow out of infections by 6-8 years old. Tubes last about 1 year then fall out. Ideally a child grows out of the tendency for ear infections about the time the tube falls out. Some kids wind up needing new tubes over and over again, but this is not super common. Surgery takes only about 3 minutes per side done under anesthetic gas in an operating room. No IV’s usually. After tubes are in, you do have to think about keeping the ears dry. My recommendation for most kids is to dry the ear with hair-dryer after swimming and place a few prophylactic drops of antibiotic. No special precautions for baths (for most kids). Custom ear plugs may also be used. After tubes are placed, if infection does happen again usually no pain because the infected pus just drains out the tube and can often be treated with just ear drops.
Basically if your child is spending a large amount of time in pain, on antibiotics, or with fluid behind the ear waiting for infection to clear then I usually just recommend placing tubes.
Just how we make the impression (or “mold”) of the ear canal has a ton to do with how well the device works, feels, and therefore how successful it is in practice. One of the commonest reasons for hearing aid noncompliance or disuse has to do with fitting issues, directly related to the feel, and indirectly related to perceived sound quality.
Lantos Technologies (Caimbridge, MA) has a pre-FDA novel device to better measure and “mold” the ear canal. The Lantos Scanner uses laser technology and a complex algorithm to produce a high-resolution map of the ear canal better than traditional impression material. This data will be used by audiologists and custom hearing aid manufacturers to more easily and accurately make hearing aid impressions.
We beleive that better impressions of the ear canal represent the next big leap in hearing aid technology. Physicians’ offices using this technology (pending FDA approval currently) should find elevated patient satisfaction and improved compliance. This will make fitting of complete-in-canal and “invisible” aids much more reliable (and painless!).
Adult-onset hearing loss affects millions of Americans and accounts
for a huge economic burden in our country. There are two major forms
of hearing loss – “sensory / neural” and “conductive”. Sensorineural
hearing loss is caused by injury to the acoustic nerve or the cochlea.
These injuries can be from noise damage, viruses, meningitis, and of
course the slow degeneration of aging. Conductive hearing loss is
most commonly from an earwax impaction, fluid behind the ear drum,
infections, or a type of ear scarring called otosclerosis.
A hearing test is a brief painless test battery performed by an
audiologist to determine what your hearing level is, how it compares
to normals, and what type of hearing loss you may have. This, as well
as a microscopic examination of the ear and eardrum will allow the
physician to make recommendations about improving your hearing.
Wax removal, antibiotics, steroids, minor procedures, and sometimes
MRI scans can be useful in sorting out the hearing loss. An
electrical hearing test, called an ABR, is often helpful as well,
especially in young children.
Sometimes the only option for improving hearing are hearing aids.
These have gotten much smaller and much more advanced over the past
decade. The smallest of which are now the size of a large pencil
eraser and are completely hidden in the ear canal. Your physician and
audiologist can make recommendations about which type and size of
hearing aid may be best for you.
Why do restaurants wreak such havoc on your hearing? The most common sort of age-related hearing loss begins the in the highest frequencies (1000Hz and above). Most speech tones are lower than this, however missing out on high pitches makes it particularly difficult when sound localization is required. Bustling busy restaurants with high ceilings are notorious for creating a lot of acoustic “noise”. Many times you will be trying to hold a conversation with more than one individual, who may not be immediately in front of you, while their voice is competing with dozens of others in an acoustically-challenging room.
Hearing loss in restaurants is usually the first sign of age-related hearing loss (or any other sort of progressive high frequency loss). The same is true for difficulty in conference rooms, conference calls, or airplanes – making it particularly difficult for busy businesspeople. All of these environments have a lot of acoustical competition. It is ironic that we evaluate your hearing in a quiet sound-proof booth, so many times your degree of listening difficulty is underestimated by a routine hearing test. Usually in a 1-on-1 quiet environment there is much less hearing trouble.
A real world test of hearing aid function is critical, which is why we stand behind our money-back policy if your hearing cannot be satisfactorily improved.