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Researchers urge caution in using ear tube surgery

Placing ear tubes in young children who develop fluid in the ears does not improve speech, hearing or psychological development, according to new research.

Currently there are two reasons for ear tube surgery -- persistent, severe ear infections and liquid in the inner ear cavity of an otherwise healthy child. Doctors have been concerned that if surgery is not used in the second case, children could face long-term developmental impairment.

"We were led to the conclusion that ear disease does not cause any developmental problems," said Dr. Jack Paradise, University of Pittsburgh School of Medicine and lead researcher of the study, which appears in the New England Journal of Medicine.

Researchers assessed speech, language and cognitive and psychological development in children at age 3 who had experienced persistent fluid in the ears during infancy and very early childhood. In the study, children either got ear tubes immediately, or researchers waited up to nine months to do the procedure if the ear fluid persisted. In the group where doctors waited, one-third of the children eventually got ear tubes.

"To many doctors this will come as a surprise because it's been a matter of some controversy and speculation and some doctors are convinced it's a problem," said Paradise. There's been a perception that children with liquid in the ear have impaired hearing, which could impact language and neurological development.

"Two and 3-year-old children are learning sounds and words and we wonder if some children are going around hearing muffled sounds," said Dr. James Perrin, with MassGeneral Hospital for Children and author of an editorial accompanying the study in the New England Journal of Medicine. "It's hard to measure hearing in these children, and we wonder 'does it sound muffled?' -- 'does it sound different?'"

Ear fluid build-up is about as common as ear infection. Children with persistent ear fluid may not have sympt
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