Making the Decision

As a parent, you may find it difficult to consider surgery for your child. You're not alone. Many parents feel this way, despite knowing that the procedure can improve their child's health. If necessary, give yourself a little time before making a decision. This way, emotions are less likely to affect your judgement. A talk with your child's pediatrician or primary care doctor may help. If you decide on surgery, you'll work with the specialist's office to set a date. The doctor may want to see your child a day or two before surgery to make sure he or she doesn't have a cold.

To Reassure Your Child

Your child is likely to be scared about having surgery. Help calm any fears by telling your little one what to expect on the day of surgery. Explain that there will be a big building and many new people. Talk about going to sleep, and assure your child that you will be close by when he or she wakes up. You may want to compare the anesthesia mask with the oxygen mask worn by jet pilots. Tell your child the mask fits over the face, just like the ones seen in cartoons or movies. Some children find it helpful to act out the exam or surgery with stuffed animals or dolls.

Preparing for Surgery

Surgery to control middle ear fluid is a simple out-patient procedure that requires few preoperative instructions. Unless you're told otherwise, stop giving your child food and drink (NPO) at least 4 hours before the scheduled arrival time. Depending on the hospital or surgery center, your child may be asked to come in pajamas or to put on a surgery gown at the facility. Your child's temperature will be taken to rule out any active infection, which could require postponing surgery. At some point before the procedure, you - as parent or legal guardian - will be given a consent form to sign. If surgery includes treatment for adenoids or other problems, additional preparation, such as blood tests, may be needed.

Learning About the Anesthesia

Upon arrival, your child may be given a mild sedative to help him or her relax. Then, right before surgery, your child will breathe a small amount of gas. This light general anesthesia allows children to sleep through the procedure. In most facilities, the anesthesiologist or nurse anesthetist will talk with you before surgery. He or she will explain the possible risks of anesthesia, which include the following:

• Sluggish or cranky behavior upon waking
• A short bout of vomiting
• A rare allergic reaction, which may cause breathing problems
• Temporary heart rhythm problems

Surgery Risks

In the vast majority of cases, surgery to control middle ear fluid is a useful procedure. But, as with any surgery, some risk is involved. Risks include the following:

Stiffening or other changes in the eardrum
A tiny hole in the eardrum
Bleeding, if other procedures are included

A Quick Recovery

After surgery is completed, your child will be taken to a recovery area. There, nurses will monitor your child's condition until the anesthesia wears off. Once fully awake, your child should be able to go home. in fact, even after adenoid surgery, most patients go home the same day. Although your child can soon return to normal activities, be aware of the signs that require calling the doctor.

With Tubes in Place

Your child's hearing should improve once the tubes are in place. In addition, if middle ear problems were making it hard for your child to learn to talk, you should soon notice a change for the better. For best results, follow up as instructed by your child's doctor. In some cases, ear problems may continue. However, you can help prevent ear infections by using good ear care.

Follow-up

Shortly after the surgery, the ENT specialist may want to examine your child. This follow-up visit ensures that the tubes are still in place and that your child's ears are healing. In some cases, hearing may be retested to verify improvement. If other middle or inner ear problems exist, they're more likely to be found now. Hearing problems due to allergy-related symptoms may also be easier to identify now. After the initial follow-up, the doctor may want to see your child every 2 to 6 months. Do your best to keep these visits. They're the only way to make sure the tubes remain in place and stay open.

Fewer Problems

Even with tubes, your child may still get acute infections. Cranky behavior, ear drainage, and fever are all clues that you should be calling the doctor. However, as long as the tubes are working, you can expect fewer problems and a quicker recovery. If an infection does occur, treatment probably will include oral antibiotics and eardrops. Always make sure your child finishes the entire prescription. The medication will not work, otherwise. If a tube becomes clogged, your child's ENT specialist may be able to reopen it.

Ear Care

Help your child avoid ear infections by teaching good ear care. The tips below are especially helpful for children with tubes.

• Ask the doctor if your child's ears should be protected from contact with water. Some doctors want children with tubes to wear earplugs during swimming and bathing if they put their heads under water.
• Make sure your child doesn't dive into the water or swim far beneath the surface in deep water. Pressure from these activities can be hard on the ears.
• Teach your child not to use cotton swabs. used carelessly, they can clog tubes with wax or even damage the eardrum.
• Don't worry, neither fingers nor earplugs can push the tubes in or pull them out.

Tubes Aren't Forever

Tubes can improve hearing, helping to make learning and living easier for your child. But tubes don't last forever. They aren't meant to. Most tubes remain in place for 6 to 12 months. Some last a little longer. The life of the tubes usually depends on your child's growth. As your child gets bigger, the ear and Eustachian tube mature. After a growth spurt, one or both of your child's tubes may fall out. The slit in the eardrum usually closes soon after. If the tubes remain in place longer than two years, they are less likely to come out on their own. Depending on the situation, your child's ENT specialist may decide to leave the tubes in place or to remove them and close the holes. If ear problems return after the tubes are out, your child may need another set.