“Watchful Waiting”: New Ear Tube Guidelines - One-Minute Parent

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Nearly 670,000 ear tube surgeries are done on children under age 15 annually. It is the most common outpatient surgery performed on kids in the U.S., says the National Center for Health Statistics. By age 3, nearly one in 15 kids have received tubes.

It’s called “watchful waiting,” and it’s a new guideline for doctors on ear tubes in kids: Not every kids needs them to relieve excessive fluid build up in the middle-ear canal, says a first-ever clinical guideline for physicians just out today.

In cases where an otherwise healthy child gets middle-ear fluid, insertion of the tiny tubes (for drainage and ventilation) is not always necessary, the guidelines say. Kids can get better on their own especially if the fluid is present for less than three months, according to the American Academy of Otolaryngology. Another instance where it’s good to watch and wait is if the child has frequent or recurrent ear infections (acute otitis media) without fluid buildup.

Nearly 670,000 ear tube surgeries are done on children under age 15 annually. It is the most common outpatient surgery performed on kids in the U.S., says the National Center for Health Statistics. By age 3, nearly one in 15 kids have received tubes.

Although tubes are widely used, this is the first evidence-based guideline designed to identify children who shouldn’t get tubes and those who should. Watchful waiting is the better option for otherwise healthy children with a buildup of middle-ear fluid. This does not apply to certain children who are at-risk for pre-existing developmental delays (such as hearing loss), autism-spectrum disorder, Down syndrome and cleft palate.

The new guideline covers children ages 6 months to 12 years old but middle-ear disease is very different in young children and older children.

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