You'll find hundreds of files on cleft lip, cleft palate here on

This one is about: More On Ear Tubes

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Joanne Green responds to a parents concerns on ear tubes:

>I feel as though I am being pushed into having them put in, even though my 
>son has never had a problem. His hearing has tested positive, no ear 
>infections, and only a slight build up of fluid. The ENT tells me that if 
>we put in the tubes during his lip repair, it will save my son from having 
>to be put under anesthesia again later. I will probably bend, and allow 
>them to put them in, only because they don't hurt anything, and I really 
>feel pressured.

You, as his parent are the one to make the final decision here. You have to look at it in terms of probabilities and worst case scenarios. For instance, as you make your decision. one of the things you CANNOT decide is "We will not put in tubes and he will never have an infection." You CAN choose "We will not put in tubes and the probability is that he will not have an infection." Or you can choose, "We will put in tubes because the probability is that he will begin to have recurring infections if we don't" - those are your two choices.

Now, look at worst case scenarios. If you do not put in the tubes, and worst case scenario is that he then develops recurring ear infections - what can happen? Pain, temporary hearing loss, possible permanent hearing loss, risk of major infection such as encephalitis, or we put him under general anesthesia and put the tubes in after all.

If you do put the tubes in when, worst case scenario, you did not have to do it - what can happen? The tubes will fall out eventually on their own and the myringotomy holes will heal over. A small scar will be left on the ear drum. (And a very rare possibility that the child may have some sort of reaction to the tubes themselves)

Now you need to weigh the probabilities of worst case scenarios actually happening, and whether or not you feel you could live with it if it did. Recurring ear infections would result in you deciding to have them put in anyway. How bad would that be? What is the probability that that would happen? Prophylactic tubes would require no action later. A very rare allergy to the tubes would necessitate that the tubes be removed. What is the probability of that happening? How bad would it be if it did?

And one final variable is - what does your doctor recommend? He's the one with a lot of cleft experience, and he's the one who will be doing all the work.

The choice is entirely yours. We just need to make sure that we make informed choices.


Note: It turns out that the surgeon recommended it, because there was a need, but his lack of explanation to the parent caused her to question the need. Ask your doctor why he thinks your child needs it. After the tubes were put in, she noticed a marked improvement in hearing.

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