But in a study of 429 children with persistent cases of fluid buildup, Dr. Jack L. Paradise and colleagues at Children's Hospital found that it made no difference whether they implanted the tubes as soon as possible or if they waited up to nine months to decide. Either way, the children scored about the same on tests of their speech, language, thinking ability and psychosocial development at age 3. The findings are being published in today's issue of the New England Journal of Medicine . Dr. Heidi Feldman, one of the co-authors, said she expects the study may cause doctors and parents to think twice about the procedure. Though implanting the tubes is simple, placing small children under general anesthesia always carries risks and some children may suffer complications, such as hearing loss or discharges of pus.
Tubes are overdone.
But many parents express relief after tubes are inserted and their children start sleeping through the night, he added. In an editorial accompanying the Paradise article, Dr. James Perrin, director of general pediatrics at Massachusetts General Hospital, said health care providers should exercise caution when referring young children for ear tubes. Now that the procedure seems to have no effect on child development, doctors must consider whether reducing short-term hearing loss and decreasing the persistence of effusion are enough to justify its real, though apparently small, risks. The study was massive in size, enrolling more than 6,000 infants in the early 1990s who were examined monthly until they were age 3. This enabled the researchers to identify children with otitis media who didn't have symptoms and also to know precisely how long fluid had been in the ear, Feldman explained.