ear surgery
Ear tubes don't make a difference in learning
Study delivers blow against common childhood procedure
Children are frequently
prescribed ear tube surgery with the rationale that the surgery preserves
normal learning and behavior through primary school A recent study, however
challenges this practice with evidence contrary to routine
pediatirc practice.
Read the article in its entirety here:
http://www.msnbc.msn.com/id/16673576/
Ear Tubal Surgery for better Hearing: A Look at the facts.
The team enlisted 6350 healthy babies from birth to 2 months old and have regularly
measured fluid in these children's ear up until their third birthdays. If children
developed significant fluid in the ears that lasted for at least 3 months straight
or 4 out of six months, half of the children received ear tube surgery. The
other half waited for 6 to 9 months longer and then had surgery only if the
fluid remained. What was the outcome? When the children were 4 years old, they
received an extensive battery of intelligence, development, speech, language,
and behavioral tests, looking at verbal and nonverbal growth. No difference
could be found between the early and late treatment groups. Researchers will
continue to follow these children as they grow up. But for now, this large,
carefully designed study has found no developmental benefit from rushing to
ear tubes for young children.
-August 2003 Pediatrics. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12897272
Their
more recent study confirms that the surgery in 2-3 year olds does not improve
hearing abilities when they reach 5-6 years of age. "In otherwise healthy children who have
persistent MEE during their first 3 years of life, ready
resort to M&T results in far more TM abnormalities at
age 5 than does selective management in which most children
do not receive the procedure. With these differing approaches,
however, hearing levels at age 6 do not differ. Regardless
of whether children with persistent early-life MEE receive
M&T, they have more TM abnormalities at age 5 and negligibly
poorer hearing at age 6 than do children who had less or
no otitis media. "
-July 2004 Pediatrics
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15231974
Adenoidectomy not more effective with Ear Tubal
Surgery
In children younger than 2 years, concurrent
adenoidectomy during the insertion of tympanostomy tubes
does not seem to have a major advantage over the insertion
of tympanostomy tubes alone in preventing otitis media.
Mattila PS, Joki-Erkkila VP, Kilpi T, Jokinen J et. al Prevention
of otitis media by adenoidectomy in children younger than 2 years Arch
Otolaryngol Head Neck Surg 2003 (Feb); 129 (2): 163-168
Ear Tubes do not Decrease Antibioic Treatment
Parental expectations to antimicrobial treatment
and awareness about resistance development appear to influence
treatment strategies for AOM. The high rate of tympanostomy
tube placement in preschool children does not result in reduced
antimicrobial consumption.
Arason VA, Sigurdsson JA, Kristinsson KG, Gudmundsson S Tympanostomy
tube placements, sociodemographic factors and parental expectations for management
of acute otitis media in Iceland Pediatr Infect Dis J.
2002 (Dec); 21 (12): 1110-1115
Ear Tubes not Necessary after 16 months of age
Spontaneous recovery from recurrent acute
otitis media is common with increasing age. Thus, until reliable
causal evidence between recurrent otitis media and developmental
disability is presented, chemoprophylaxis or tympanostomy
tubes seem superfluous for most infants after the age of
16 months.
Alho OP, Laara E, Oja H What
is the natural history of recurrent acute otitis media in infancy? J
Fam Pract 1996 (Sep); 43 (3): 258-264
Ear Tubes Not Worth the Risk or Cost
Implanting ear tubes,
an operation done on hundreds of thousands of toddlers each year, does not
appear to improve their speech and learning development and
may not be worth the risks and the cost, a study suggests. Researchers
in Pittsburgh looked at two groups of toddlers: those who
got ear tubes after three months of fluid in their ears (the
standard guideline) and those who waited up to nine months
before tubes were inserted. The children were tested for
speech, language, learning and behavior when they turned
3. "The bottom line was there wasn't any difference
in the developmental outcomes as best we could measure them
at age 3," said Dr. Jack L. Paradise of Children's Hospital
of Pittsburgh.
Paradise said there is a risk of complications from the anesthesia.
Also, he said, the tubes sometimes leave perforations in
the eardrums or scar them, or cause chronic drainage from
the ear. "If tubes were absolutely harmless
and free, then I think you might say, 'Well, let's have the tubes to be sure,"'
Paradisesaid. "But tubes themselves carry risk and, of course, there's cost involved.
So it becomes a matter of ... which set of risks would you rather take? Paradisesaid
he would hold off inserting tubes if the only concern was developmental problems
from hearing loss.
Hoffman RA, Madell JR Effect
of early or delayed tympanostomy-tube insertion for persistent otitis media N
Engl J Med 2001 (Aug 9); 345 (6): 465; author reply 465-6
Tubes in the Ear Not Beneficial
Whether or not to give a child
tympanostomy tubes.... tubes in the ears... is a debate that has raged
in medicine for two decades. One of the major arguments
in favor of tubes is that if children have fluid behind the
middle ear it can cut down on their ability to hear and potentially
lead to learning problems. But a report in the New
England Journal of Medicine says this is not the case. According
to the report, in children younger than 3 years of age who
have persistent otitis media, prompt insertion of tympanostomy
tubes does not measurably improve developmental outcomes. The
procedure has little long-term benefit with respect to hearing
behavior or learning and development.
Paradise JL, Feldman HM, Campbell TF, et. al. Effect
of early or delayed insertion of tympanostomy tubes for persistent otitis media
on developmental outcomes at the age of three years N
Engl J Med 2001 (Apr 19); 344 (16): 1179-1187
Tube Surgery both Expensive and Frequently Ineffective
Myringotomy and tympanostomy with tube implantation
are frequently both ineffective and expensive.
Gates GA; Wachtendorf C; Hearne EM; Holt GR Treatment
of chronic otitis media with effusion: results of tympanostomy tubes Am
J Otolaryngol 1985 (May); 6 (3): 249-253
Gates GA; Wachtendorf C; Hearne EM; Holt GR Treatment
of chronic otitis media with effusion: results of myringotomy Auris
Nasus Larynx. 1985; 12 (Suppl 1): S262-264
Another Reason to Avoid Ear Surgery
According to researches at Children's Hospital
of Pittsburgh and the University of Pittsburgh, Inserting
tubes in the eardrums of children under the age of 3 has
no measurable effect on improving speech, language, cognitive
or psychosocial development.
The researches studied 588 3 year olds from infancy and concluded that their
findings provided no evidence that the insertion of ear tubes improves a child's
developmental progress. Approximately 280,000 children under the age of 3 have
tubes inserted annually.
Before Ear Surgery read this: What are risks and complications
of ear tubes? http://www.medicinenet.com/ear_tubes/article.htm
Consider chiropractic
before ear surgery
The
Otitis Media Page @ Chiro.Org
Please Visit: http://www.chiroweb.com/archives/12/20/04.html for
an additional article on treatment of Otitis Media