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Patient Information
Patient Information
What should I do if my child has frequent ear
infections but no persistent fluid (effusion) behind the
eardrum in the middle ear?
1. Why am I receiving this information sheet?
You are receiving this information sheet because your doctor has not
recommended ear tubes for your child, even though they have had frequent ear
infections in the past and may have been referred to the specialist specifically for
ear tube surgery. The information that follows will clarify why it is in your child's
best interest to hold off on ear tubes for now, recognizing that this decision could
change if your child continues to suffer from frequent ear infections.
2. What is middle ear fluid, also called effusion?
When a child has acute otitis media or an ear infection, they have fluid and germs
in their middle ear, behind the eardrum. Middle ear fluid is also called an effusion,
which is typically cloudy and full of bacteria and white blood cells in the worst
part of the ear infection. We call this a purulent effusion, commonly known as
pus. As the ear infection goes away the effusion is absorbed by the body or drains
through the eustachian tube, a connection in the skull between the ear and back
of the nose. This process can take several weeks, but within 3 months about 90%
of children no longer have middle ear fluid. So, it would be perfectly normal for a
child to have an effusion when an ear infection is first diagnosed but they may not
have a persistent effusion when they are examined days or weeks later.
3. What does it mean if my child has repeated ear infections, but
doesn't have middle ear fluid (effusion) when they are seen by an
otolaryngologist (ear, nose, and throat doctor)?
For most children, if their elusions completely clear up bet ween their last
infection and the time they are seen in a surgeon's office, it means that their
eustachian tubes work well Even if these children meet the definition of having
had frequent ear infections (3 or more in the past 6 months, or 4 in the past
12 months), we know from research studies that nearly half will not have more
ear infections and only about 1 in 3 will continue to have frequent infections.
Other research shows that 2 out of every 3 children who see an otolaryngologist
for repeated ear infections, but who have a normal examination (no middle ear
fluid) in the office, do not require ear tubes in the future. If your child, however,
continues to have frequent ear infections, they should be reevaluated by the
otolaryngologist and may qualify for ear tubes in the future.
