Conditions that require ear tubes in infants include recurring ear infections, a predisposition to hearing loss, and difficulty with ear infections during certain times of the year. For some doctors, simply having too many recurring ear infections is reason enough to place ear tubes in an infant's ears because infections can lead to delays in development. Sometimes, a concurrent condition or disorder causes greater concern for sensory development and will lead a doctor to implant ear tubes. Even the time of year that ear trouble begins can influence whether or not ear tubes are considered the correct course of action.
Acute otitis media is characterized by the presence of fluid in the middle ear, significant pain and discomfort, fever, and often a swollen eardrum. Infections such as this can be difficult to resolve and sometimes lead to fluid remaining in the ear for several months, causing recurring infections. When this happens three times in six months or four times in a year, there is concern for the comfort and well being of the child and ear tubes are usually considered necessary treatment. Otitis media with effusion also refers to fluid in the middle ear, but with less pain and bothersome symptoms, and is typically less of a cause for insertion of ear tubes in infants. Ear tubes are still an option, however, when the fluid causes a prolonged, significant reduction in hearing, as this can affect the speech development of young children.
The use of ear tubes in infants is generally related to fluid and infection in the ears, but the time when this treatment is considered necessary can be influenced by other conditions or disorders. A child with changes to his or her craniofacial structure, due to a condition such as cleft palate or Down's syndrome, would probably need tubes sooner because the structure of the face can make fluid in the ear much harder to treat and prevent. Also, a preexisting condition, such as autism or previous hearing loss that is affecting the child's sensory development, can result in earlier placement of ear tubes. For children who are already experiencing a developmental delay, further fluid build-up in the ear is more of a cause for concern.
When a child begins to have trouble with ear infections, the time of year often affects how long the recovery will take. Generally, recurring fluid in the ear is harder for a child to recover from during the fall and winter seasons. The colder weather, along with exposure to more germs from cold and flu season, may cause some doctors to insert ear tubes in infants more often during this time of the year.