Ear Issues Addressed at Ears, Nose, and Throat of ENT Tulsa
Here at Ears, Nose, Throat of ENT Tulsa, we provide treatment for various ear diseases. One of the most common procedures done in America is the placement of ventilation tubes. This is primarily for children but we have done our fair share of adults. Nearly every child experiences at least one episode of an ear infection. Most of them will resolve on their own or are effectively treated with antibiotics, but sometimes infections (or even fluid) can be maintained in the middle ear space and become a problem. This needs to be addressed by surgical methods such as placing a tube through the tympanic membrane. If your child is having trouble with phonics or having a poor school performance, or having behavioral issues, it could be misconstrued for not paying attention or just defiant. Sometimes the explination is that your child is not hearing well.
If you or your child have any of these issues a hearing test can be performed at Ears, Nose, Throat of ENT Tulsa to identify whether these issues are at least contributing to the above factors. If it turns out that your child is having recurrent ear infections or that fluid is being maintained in the middle ear space, this can be identified through an audiogram, which is basically a hearing test with other specialized tests that can help us identify if there’s fluid or if there’s a lot of negative pressure in the middle ear space. If that turns out to be the case, (if your child has three episodes in more than 6 months or if your child has fluid that’s persistent in the middle ear space for longer than 2 to 3 months), then they may be a candidate for tube placement.
What are tubes? Ear tubes essentially ventilate the middle ear space. There is a natural tube called the Eustachian tube that drains to the back of the nose. It’s normally closed, however when we swallow, we need to equalize that pressure in the middle ear space. It will come open and equalize the pressure in the middle ear space to match the ambient air pressure. Sometimes it doesn’t function normally and will not open up, ventilating the middle ear space. Negative pressure then fills that middle ear space and it’s the negative pressure that pulls fluid from the surrounding cells. And now you have a warm, moist, dark area with fluid accumulation, and that is a setup for infection. At Ears, Nose, Throat of ENT Tulsa, this is a common condition we see.
Placement of ear tubes is a very simple procedure we perform at Ears, Nose, Throat of ENT Tulsa where we use a gas mask to provide anesthesia for approximately four to six minutes. The tubes are then placed. It’s very safe because of the minimal amount of anesthesia, but it’s also safe, because it’s very minimally-invasive. Essentially it involves a small microscopic incision in the eardrum with the placement of an ear tube that has a flange on each side of the eardrum. That’s what holds it in place.
There are many different types of tubes. Some are more short-term, others last a little longer, and we have other tubes that are permanent. This should help your child in a number of areas. Obviously, it should increase their ability to hear which also improves their speech. Most children will learn how to speak around the age of 2. It is a crucial aspect for them to be able to hear well so that they then can speak well. If you can’t hear well, you won’t be able to speak well. We repeat exactly what we hear while learning to speak, if we have fluid in the middle ear space it will make the sounds like hearing underwater. This will then be repeated by the child.
It also can help with balance problems. Obviously it may also help with behavioral and sleep problems relieving potential pain occurring in the middle of the night (helping parents sleep all night too). This reduces the risk of any future infections and can help the children hear so that they can then progress with their learning in a more normal fashion. Usually, tubes stay in place anywhere from 6 months to 2 years. The average is approximately one year when considering all of the patients we’ve treated at Ears, Nose, Throat of ENT Tulsa.
There are some complications that can occur from tubes. Although it’s unusual, one of the most common problems is a perforation in the eardrum after the tube comes out. Most people don’t realize that the skin in the ear canal, from the eardrum to the outer part of the opening of the ear canal, will grow out like your fingernail. That’s what essentially brings that tube out over such a long period of time. Just like your fingernail growing out at a very slow pace, so does this skin. As that tube comes out typically, that eardrum would completely heal. However, there are cases where it does not heal, and Ears, Nose, Throat of ENT Tulsa has to go back and put a little paper patch over that hole to allow it to heal. It merely severs as a template for the ear drum to grow and close.
Obviously inserting tubes can also cause some scarring. That scarring typically causes no problems and also of note really causes no problems with hearing. Occasionally, the tube will colonize (harbor the bacteria) bacteria and will be the cause of continued infections. In this case, it does the opposite of what it was intended and it may need to be replacing with a new fresh new tube which Ears, Nose, Throat of ENT Tulsa faces frequently.
Other complications would include the ear tubes coming out too early. Ears, Nose, Throat of ENT Tulsa had some cases where it would come out in just a couple of weeks. Obviously we want those tubes to stay in there for a year, or maybe even two. Dr. Cordray had other cases that would migrate into the middle ear space, where they would have to be retrieved from the middle ear space. Other cases where the tubes would just get stuck and they wouldn’t come out on their own and we have to go in and retrieve those tubes out of the ear canal.