“The age of the children in the study … coincides with what is considered the sensitive period for speech and language development,” Cosetti said.
Unlike antibiotics, he explained, “ear tubes” can provide immediate relief hearing loss related to middle ear fluid, the value of which may be difficult to quantify in the current study. “
For Sobol, the study “emphasizes the importance of creating an individualized approach to management.”
The trial included 250 children, aged 6 months to almost 3 years, who had suffered recurrent middle ear infections, at least three in six months or four in one year.
Hoberman’s team randomly assigned them to have an ear canal surgically placed or to receive oral antibiotics each time a new infection occurred.
Children with ears also received antibiotics when a new infection arose, but by ear drop. If that didn’t work, they switched to oral antibiotics.
One of the potential benefits of ear tubes, Hoberman noted, is that they allow antibiotics to fall out of the ear. This could reduce the risk of bacteria developing anywhere else in the body antibiotic resistance.
However, during the two-year study, there was no clear advantage of ear tubes when it came to new infections or antibiotic resistance.
The average rate of recurrent ear infection was about 1.5 per year in the ear canal group and 1.7 in the comparison group. Infections decreased in the second year in both groups.
The study found that children with hearing tubes spent fewer days on oral antibiotics.
But the two treatment groups showed no difference in the likelihood of having antibiotic-resistant bacteria in their nose or throat.
However, Sobol noted, there were some other advantages in the ear group.
On the one hand, they tended to remain free of infection for 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, Hoberman said, the ear tubes carry risks, albeit small ones. During the procedure, there may be bleeding or reactions to anesthesia. In the longer term, the tube may become blocked or cause structural changes to the eardrum.