One of the most common fears for parents is the general anesthesia that almost all children have to put in ear tubes. Is this fear rational? Quite frankly, no, but it is real to those parents nonetheless. Driving in your car and experiencing a significant injury from an accident is more likely than anything bad occurring when having anesthesia for ear tubes.
Placing ear tubes is the most common minor surgical procedure done on children today. The most common reasons are: too many ear infections, fluid in the ears for too long and an associated hearing loss or speech delay, and ear drum abnormalities which can become very unsafe for the health of the ear.
The procedure requires removing the wax from the ear canal, making a cut in the ear drum in the right place, suctioning out fluid from behind the ear drum, and placing a tube in the opening. Some surgeons irrigate out the middle ear; some place ear drops in the canal.
The part that is most annoying to children are being put to sleep with the mask (the gas is stinky and some are understandably afraid)–most will cry even when parents are present. If pain medicine is not given during the short procedure, most have pain afterwards. Of course, no eating typically for 8 hours before or drinking for 4 hours before is difficult to imagine, although not as difficult to have happen, as many parents find out.
Now the good news! There is an alternative for some children who need ear tubes.
First, the history. In 1999, I led the first study of a laser that would be used in the office, without general anesthesia, to place ear tubes in the office. A few challenges prevented widespread adoption–the uneven local anesthesia in some children, annoying loud sounds that the suctioning made (with bad memories of the experience) and the lack of reimbursement to the physician for trying to avoid the extra costs of the OR and anesthesia and pay for the equipment.
With the advent of cost containment, the safe use of medications that reduces anxiety and produces amnesia, and better topical anesthesia, this procedure is being done in the office setting once again. Its use is widespread in some parts of Asia and Europe.
And now in Buffalo, NY. During the last year, more than 30 children have had this in my office. Almost every parent was very satisfied, and none of the children came back afraid to have their ears examined. One family came back a second time.
Right now only Blue Cross and Blue Shield insurance products will pay for this procedure in the Buffalo area. We are hoping to expand this to the other insurance carriers. Also, not all children (or all parents) are good candidates for this because of narrow ear canals, the type of ear problem, and parent sensitivities to seeing their children cry when in a papoose, which we use to help the little ones hold still so we can steady their heads.
So if you have a child who might need ear tubes or know someone who does, you might want to let them know there is an office based alternative that is as safe, more convenient, and less costly than having ear tubes under general anesthesia. It is also used, without placing tubes, for very painful ear infections that are not responding to antibiotics and pain medications if the child is very sick. Drainage can be done for immediate relief.
If you want to know more about this procedure, you can find me at www.wnykidsent.com or call my office at 716-362-9730. Hope you found this helpful.