“The ages of the children in the study… coincide with what is felt to be the sensitive period for speech and language development,” Cosetti said.
Unlike antibiotics, she explained, ear tubes “can provide immediate relief from hearing loss related to middle ear fluid – the value of which may be difficult to quantify in the current study.”
For Sobol, the study “underlines the importance of creating an individualized approach to management”.
The trial included 250 children, aged 6 months to almost 3 years old, who had suffered from recurrent middle ear infections – at least three in six months, or four in a year.
Hoberman’s team randomly assigned them either a surgically placed ear tube or oral antibiotics whenever a new infection occurred.
Children who received ear tubes were also given antibiotics when a new infection occurred – but by ear drop. If that didn’t work, they switched to oral antibiotics.
A potential benefit of ear tubes, Hoberman noted, is that they allow antibiotics in the form of ear drops. This could reduce the risk of bacteria elsewhere in the body developing resistance to antibiotics.
Over the two-year study, however, there was no clear benefit of the atrial tubes when it comes to new infections or antibiotic resistance.
The average rate of recurrent ear infection was approximately 1.5 per year in the atrial tube group and 1.7 in the control group. Infections decreased in the second year in both groups.
The study found that children with ear tubes spent fewer days on oral antibiotics.
But the two treatment groups showed no difference in the likelihood of harboring antibiotic-resistant bacteria in the nose or throat.
Still, Sobol pointed out, there were other benefits in the ear tube group.
For one thing, they tended to stay infection-free longer before their first recurrence. They also generally had fewer days with symptoms of infection – with the exception of ear drainage.
At the same time, said Hoberman, ear tubes carry risks, even if they are small. During the procedure, there may be bleeding or reactions to the anesthesia. In the longer term, the tube can become blocked or cause structural changes to the eardrum.
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