Ear Tubes

[aligreat]

Right now, the doctor is trying to get us to have tubes placed in Cassia's ears. She has never had an ear infection, but she often has fluid in her ears. The doc says that it could improve her hearing 5-10 db, but that really doesn't seem like much of an improvement for a 90+ db loss. I just don't feel good about it. Cassia is scheduled for surgery on January 5th to have her lingual frenulum (sp?) clipped, and the doc wants to put the tubes in at that time. We always try to do procedures requiring anesthesia together since we have a family history of a fatal anesthesia allergy. (We are also trying to schedule a follow-up sedated ABR hearing test for that day.)

Any thoughts? I would love to hear any experiences (positive or negative) that you all have had.

[MmaBasotho]

Our doc says that middle ear pressure may explain why Paula takes her aids out so much, and is also recommending tubes. She would also get the long-awaited ABR that day.

It seems like a good idea... I guess I'm willing to try almost anything right now, and dh and I really want that ABR. The audi has not recommended one because she feels the sound field tests are giving her good results. I'm not so sure - Paula has an amazing ability to screen out what she does supposedly hear.

I hope somebody else comes along here with something constructive to say! For now, we're in the same boat.

[aligreat]

Our doc says that middle ear pressure may explain why Paula takes her aids out so much, and is also recommending tubes. She would also get the long-awaited ABR that day.

It seems like a good idea... I guess I'm willing to try almost anything right now, and dh and I really want that ABR. The audi has not recommended one because she feels the sound field tests are giving her good results. I'm not so sure - Paula has an amazing ability to screen out what she does supposedly hear.

I hope somebody else comes along here with something constructive to say! For now, we're in the same boat.

Cassia had an ABR done last year that shows she has 90+ db loss bilaterally. When she has her "hearing tests" done in the little sound booth she registers at 60-80 db loss. I don't trust these results because they sound a tone in her ear to see if she looks for where the tone came from, and then they flash lights to see if she looks for them. If she is getting a visual cue, how is that testing her hearing? :confused: Also, the audiologist in the booth, talking to the other audiologist behind the controls outside usually says things like, "I think so." or "She blinked." to indicate that there was some sort of behavioral response to the noise. Well, I blinked too, and I didn't hear the tone. I guess that I just trust the ABR as being more reliable and more valid.

[Krista]

I"m not sure how constructive this will be but here it is anyway, lol. IF she has the tubes put in, won't they have to wait to do the ABR then? What is the Dr's opinion on what the difference a 10 dcb change will be for her? I had tubes put in my ears a LOT when I was a kid (chronic ear infections which is the blame for most of my hearing loss), and I don't remember hearing better, but I do remember feeling less pressure there (though I never noticed it before the tubes, kwim?). This isn't advice, but maybe more to think about- I don't know, lol, sorry. :confused:

[devoefamily]

Hi,
Thomas has had four sets and with the sets he heard the same. In June they suggested doing a new set. At that time one was out and the other coming out.
The Dr. told me they couldn't tell if he would hear better but it would help with fluid.
Thomas doesn't get any ear infections (Knock on wood ;) ) but they said it might help with his fluid.
I looked at the doctor and said no, he will always have fluid until his palette is completely done. He still has a small opening and since that is there and it connects to ear canals, sinus cavity he will have fluid.
I will tell you what we saw with the tubes is drainage from the ears more then you would see without them.
He had an ABR done 2 weeks ago and if they can do it altogether have it done that way. Getting a child to take the sedation is horrible. It smells and tastes nasty! :eek:
Take care and good luck
Lori

[bobica]

Hi! Siobhan is scheduled for tubes wednesday morning. She has normal hearing levels prior to fluid, a bad history of ear infections & now chronic fluid since september. We had her hearing tested in the booth & she consistently responded at 50 db! So she's got a moderate loss from the fluid :(

I agree with doing procedures together, and a 10 db gain could make some functional difference. But from 90 to 80- not a huge functional difference. However, if her fluid is chronic, the pressure could be bothering her.

FWIW, i've heard of great results for fluid drainage with chiropractic adjustments. I wish i had heard of that before her ears got so bad! :o

I'll post more after the procedure!

[Kei_as_in_K]

Hi! Siobhan is scheduled for tubes wednesday morning. She has normal hearing levels prior to fluid, a bad history of ear infections & now chronic fluid since september. We had her hearing tested in the booth & she consistently responded at 50 db! So she's got a moderate loss from the fluid :(

I agree with doing procedures together, and a 10 db gain could make some functional difference. But from 90 to 80- not a huge functional difference. However, if her fluid is chronic, the pressure could be bothering her.

FWIW, i've heard of great results for fluid drainage with chiropractic adjustments. I wish i had heard of that before her ears got so bad! :o

I'll post more after the procedure!

How did everything go? Please update when you get a chance.

[bobica]

a raving success! she went from a moderate loss to hearing whispers! the procedure was unreally quick- i stayed with her as they put her under :( and then left. 20 min later the dr came out to say that it had gone well & she was awake in recovery! awake???!!! :eek: we walked in & she was crying for me. they unhooked her & gave her to me.

she looked at me, still a little out of it, cried "mommy." i told her i was right there & she said "please can i have a snack?" amazing how nothing kills her appetite! she ate up a storm in recovery (and most of the day at home). in a 2 hour span, she was prepped, knocked out, operated on, recovered & we were in the car on our way home.

she had some pain & we have to put drops in for the next few days. follow up on the 28th where we'll probably have another audiological (i'm hoping). it's just amazing to see her happy again. she even slept through the night! (it's been months!)

on to the next challenge, i guess! :confused: :p

[MomofJBN]

Yay! I'm glad it was such a success.

[ajberchielli]

My Tyler had the PE tubes placed in May 2005- (22.5 months old), prior to that he had constant fluid in his ears since like 1 month old. March(19.5 months) he had his hearing tested at the mild/moderate loss range(b4 surgery). He's had several ear infections after his 1st b-day too.
His last hearing test in August '05 (26 months) he tested at the mild to almost normal hearing level. His speech has improved dramatically b4 tubes he had >5 verbal words and now he's at 75 words and just after xmas he will be 2.5 yrs old! Last week we saw the doc and PE tubes are still in place 6 months later. Only time will tell.

Hopefully he won't be anything like his daddy and need several PE tubes and still have hearing loss. We shall see.

good luck!

[aligreat]

Thanks for sharing some positive experiences. I don't have any illusion about tubes completely correcting a 90 db hearing loss, but I'm more open to the idea if the doc still thinks it is a good idea. Cassia has never had an ear infection despite often having fluid, and it doesn't seem to bother her at all. Also, I had a cousin who had tubes all growing up and always seemed to have problems with them. My main thought is why do something that might cause her problems, when the current condition isn't bothersome?

[Kei_as_in_K]

a raving success! she went from a moderate loss to hearing whispers! the procedure was unreally quick- i stayed with her as they put her under :( and then left. 20 min later the dr came out to say that it had gone well & she was awake in recovery! awake???!!! :eek: we walked in & she was crying for me. they unhooked her & gave her to me.
she looked at me, still a little out of it, cried "mommy." i told her i was right there & she said "please can i have a snack?" amazing how nothing kills her appetite! she ate up a storm in recovery (and most of the day at home). in a 2 hour span, she was prepped, knocked out, operated on, recovered & we were in the car on our way home.


So glad to know it went so well.

I have to get a referral to an ENT for William. The tympanogram in his right ear was flat yet again, so it's time to take the next step. He's never had any ear infections, just fluid from time to time... it's hard to tell if it's an on-off kinda thing with him, or a constant state. His ear canals are so small, it's tough for his doc to get a good look, and the times where he has been successful, 4 out of 6 times there's been fluid.
Thanks for updating us!

[MmaBasotho]

I don't have any illusion about tubes completely correcting a 90 db hearing loss ... My main thought is why do something that might cause her problems, when the current condition isn't bothersome?

That's more or less where we're at. Maybe the mid-ear pressure is causing discomfort and making the aids less comfortable and less effective. If so, maybe tubes will help. Here's hoping.

The fact that the surgery has a low level of risk and fast recovery makes the decision easier to try something not knowing for sure if it will help.

I must say, though, that I really wonder what the ABR will say. We're getting it done at the same time as the ear tubes and I have a feeling they will find results highly divergent from the sound field test. It's just that Paula is so focused on what she sees in front of her (the toys they give her to play with so she won't turn around and look at the boxes all the time). I think she's bored with sound field tests... Maybe it's just wishful thinking, but yesterday she responded to me when I called her name and she didn't have her hearing aids in. I don't know - I guess I won't until we get that ABR.

[JoyJoy]

My middle DD had tubes in her ears and she has failed her Preschool hearing test she also had fluid built up again so far they have not worried about it but we might be in that direction again. I had tubes about 4 times as a kid. Thats what helped me hear. I was born deaf and totaly deaf at nine months. But ya they did help me out.

[amiller]

Take it from me - TUBES CAN HELP! And as surgeries go, it is way minor. I had tubes in ANyka's ears for the same reason, and she started talking within 2 weeks! We still think she has some hearing loss, but she has made incredible progress from not having ears full of goo!

[MmaBasotho]

The surgery went fine, no problems - much to my relief! I had been envisioning nightmare scenarios so am very pleased :)

The ABR told us more than we knew before, but it's not that different from what we had gotten from sound field testing: moderate sloping to severe snhl, both ears.

The sound field results said 60-80 dB. I'm not sure but I think she might actually be more in the 50-80 range, per the ABR? I'll know more tomorrow.

Today we're just taking it easy. Paula knocked out at 3 yesterday afternoon, woke up at 9 :( Was up till 12:30, up again from 2-4, slept again till 7:30. She's chipper as ever, I'm bushed.

[Alli]

Juliet- so glad that all went well with the tubes and the ABR. Cassidy is having an ABR next wedensday. Could they tell from the ABR if the hearing loss is from the fluid or more permanent reason? They told me that is what the ABR will do for Cass. Thanks for the info

[jodisvan]

My daughter, Katie, had tubes when she was 18 months of age after 10 ear infections. As an audiologist, I knew it was the right decision to make, but as a parent, I was a little hesitant to commit to surgery.

Fortunately, the surgery went well. We did not have to wait for long and in recovery, she cried briefly and once she was cuddled fell back asleep. That afternoon she was playing as usual. You never would have known that she had surgery that morning!

I was amazed at the difference in her babbling after the surgery. Immediately she sounded clearer and she started saying more words.

I have to point out that a conductive hearing loss can only produce a maximum hearing loss at a moderate level (55-60 dB) if it is a true conductive hearing loss.
There are several things to look for after tube placement. A flat tympanogram will still be present, however, the ear canal volume should be large indicating a patent (open) tube. A tympanogram test uses a probe to measure middle ear pressure. Since there is now a hole in the eardrum, there is a high canal volume on the test. However, there is no mobility (or movement) due to the hole in the eardrum.

When hearing is tested, we use headphones to test the whole middle ear system. Meaning: the outer ear, to the eardrum, vibrating the middle ear bones, to the cochlea (hearing organ), to the nerves, and on up to the brain. To test bone conduction, we use a bone vibrator placed on the mastoid bone behind the ear or on the forehead. This vibrator vibrates the skull and bypasses the middle ear system.

If the loss is more than a moderate loss, it most likely is a mixed loss with a sensorineural component. Thus a conductive hearing loss has to do with the middle ear, and a sensorineural hearing loss has to do with the sensory=cochlea (hearing organ), and the neural=nerve pathway. A mixed loss is a combination of the two losses.

When there is a conductive component, it means that there is an air bone gap. This means there is a gap between the air conduction and the bone conduction thresholds. The key after tubes, is to hope for a decrease in the air bone gap. You want the bone conduction results to be closer to the air conduction results.

Hope this makes some sense! My daughter still has fluid in her ears but has not had as many ear infections now that the tubes have come out on their own. My ENT told me that there is also a huge jump in immunity when kids reach age 2. Another reason infants and toddlers get so many ear infections and have so much fluid is because the eustachian tube is horizontal from birth. As we get older, the eustachian tube angles toward our throat, which helps with draining the fluid. However, this growth varies and takes some time.

One of the keys is to find an ENT you trust and like. Make sure they answer all your questions and if they don't keep asking until they do. Remember you are a consumer whether your insurance is paying or not. Even though it is minor surgery, it is surgery nonetheless. As a parent, surgery is never an easy decision.

Good luck to all of you!
Jodi Skrovan
mom to Katie (almost 3)
Columbus, Ohio

[alices_dad]

And I'll add that it's worth every penny to go to a place that custom fits hearing aids for kids and get earplugs made for bathtime or swimming. It was suggested that you could use cottom and vaseline to make one-time use plugs and we used this, but yuck. Yuck.

[jenml]

My son has had chronic ear infections (five this season alone, and I don't know how many since his first... I lost count). He was so sick a couple weeks ago that he wasn't hearing me (constantly saying, "what, what"... and at first I thought he was kidding) and turning the tv ridiculously loud... so turns out his adenoids were so swollen that they were blocking his ear canals on the inside (I didn't even know that was possible!). So he just came back from Yale New Haven Children's Hospital and the verdict is: removal of tonsils, adenoids, and placing bilateral ear tubes. Yuck. The biggest drawback will be putting him under. The doctor says it may even improve his taste (dare I get excited about this? This kid is the pickiest eater in the world), improve the snoring, improve his speech clarity (for which he was sent to a speech therapist for an eval last spring...), and of course, to decrease the recurrent ear infections....
So, with fingers crossed, he goes in Feb 17th for the triple procedure...

[c01dunlap]

My son has had chronic ear infections ....
So, with fingers crossed, he goes in Feb 17th for the triple procedure...
Good luck, Jen! I hope it all goes smoothly, and saves you all from the miseries of further ear infections, etc.

[MomofJBN]

improve the snoring,...
So, with fingers crossed, he goes in Feb 17th for the triple procedure...

I can't speak to all the issues, but Jonathan had his tonsils & adenoids out when he was 5, and that solved his snoring issues immediately. Wishing Henry all the best.

[jenml]

Good luck, Jen! I hope it all goes smoothly, and saves you all from the miseries of further ear infections, etc.

Thanks... I'm very hopeful. I just called Yale on Wednesday to get placed on the "cancellation list" (so if a scheduled kid gets sick and cancels, we'll get bumped up...), and that day they re-scheduled us for 18 days sooner... so he goes in on this coming Tuesday.
I know the surgery will be fine, but the thought of him getting put to sleep is horrible. I've gone through it (surgery) four times, so I know the process, but for such a little guy... :(
And another dreaded aspect is the "not eating" bit... that will be miserable. He's scheduled for 8:15am, but he wakes at 5... a long three hours!

Thanks for all your thoughts... I know he'll be fine.

BTW, funny story... when my husband Nick took him for his pre-op visit at the hospital (I didn't go), we called ahead and arranged an interpreter for the appointment. No plm, right? Well, when he got there, they had a Spanish interpreter there!! :eek: Happily, they understood their mistake quickly and summoned an ASL/English interpreter for him in a very timely manner. :rolleyes: