What are ear tubes?
Ear tubes, also known as PE tubes or Pressure Equalization tubes, are small cylindrical silicone or plastic tubes that are surgically placed into the ear drum.
When are ear tubes necessary?
Ear tubes are typically placed for 4 reasons:
1. Recurrent Otitis Media. This is the most common reason for ear tube placement for children between the ages of 1 and 6 years old. Tubes are generally considered for patients who are having 5 or more ear infections per year.
2. Persistent Acute Otitis Media. Antibiotic resistant bacteria are becoming more prevalent and we are seeing more and more ear infections that will not clear with oral antibiotics. If an acute infection is not clearing with 2-3 courses of broad spectrum antibiotics, ear tubes are frequently recommended.
3. Otitis Media with Effusion. Middle ear fluid is common for several weeks following an ear infection. If however, fluid persists for 3 or more months, ear tubes are frequently recommended.
4. Eustachian tube dysfunction. While most children will outgrow their tendency towards ear infections around the age of 6, some go on to have chronic Eustachian tube problems. This typically manifests as frequent middle ear fluid, ear pressure, and ear infections. Adults with these issues often have tubes placed to alleviate their symptoms.
Why do young children have frequent ear infections?
Between the birth and the age of 6, the Eustachian tube is slow to mature. As a result, children develop middle ear fluid more readily than adults. Children are also exposed to frequent upper respiratory infections. Both of these factors cause an increased risk of developing an ear infection. Additional risk factors include exposure to large numbers of children (day care or pre-school) , exposure to tobacco smoke, and congenital abnormalities of the palate (cleft palate).
How do ear tubes work?
Ear tubes act as a ventilation device, preventing pressure build up behind the eardrum. In doing so, they prevent the build up of fluid, thus minimizing the chance of developing an ear infection. Tubes also serve as a drain, allowing fluid or infection that is present at the time of surgery to be drained from the ear.
How long do tubes last?
Ear tubes generally stay in the eardrum between 6 months and 3 years. The duration is based on the type of tube used and individual variation from patient to patient.
Can I swim if I have ear tubes?
Yes. For bathing and swimming on the surface of a swimming pool, no precautions are necessary. For older children and adults who may dive deeper than 2 feet under water, ear plugs are recommended.
Is anesthesia required for tube placement?
A brief general anesthesia is required for tube placement in children. Adults can have ear tubes placed in an office setting using topical anesthesia (numbing drops on the eardrum).
Who performs ear tube placement?
Ear, Nose, and Throat specialists are trained to perform ear tube placement for both children and adults.
Thursday, August 11, 2011
Thursday, June 23, 2011
Summer ENT Care
With the arrival of summer this week, summer activities are in full swing, including regular swimming, diving and more active water sports such as water skiing, wakeboarding and tubing. While much attention is directed to safety in and on the water, we see water related ear problems every year, most of which are entirely unavoidable and random. It can be confusing as a patient trying to decide whether an ear needs to be seen and how quickly that is necessary.
Otitis externa (“swimmer’s ear”), is easily the most frequently seen ENT problem related to water activities. It accounts for numerous office visits in a specialty ENT practice, as well as in primary care offices and urgent care centers. Pain in the ear (often quite severe) with blockage and often drainage are hallmarks of this problem. The ear is often exquisitely sensitive to pressure or pulling on the visible outside portion of the ear. While this condition often responds well to antibiotic eardrops, especially when discovered early in its course, it can occasionally be difficult to resolve and may require careful cleaning with an ENT specialist employing a microscope. It is essentially a localized infection in and on the skin of the ear canal, and it can involve bacteria or fungi. Rarely, additional preventive measures may be recommended, such as preventive drops or earplugs, but that is not routinely required.
With diving, body surfing and high-speed activities such as water skiing, traumatic water injuries (especially to the ear drum) can occur, and we see and treat them regularly. The surface of a body of water (pool, lake or ocean) can effectively “slap” the ear when someone lands wrong, especially at greater speeds or from greater heights, and send a pressure wave toward the eardrum, which can injure it. This does not always produce a perforation or hole in the eardrum, but often it does. If an injury of this type is associated with lingering alteration of hearing, pain or drainage beyond 24 hours, it is wise to be seen by an ENT specialist for a careful examination of the ears, often including an audiogram. The vast majority of injured eardrums will heal on their own and do not require any treatment; however, the drum will occasionally require attention at the time of injury to avoid failed healing and a bigger procedure later.
A similar blow to the ear with associated significant dizziness can represent a far more serious condition requiring immediate attention. While mild disorientation and brief dizziness may seem normal after wiping out on a wakeboard or with similar incidents, any severe and persistent dizziness should be evaluated as promptly as possible, to be certain a potentially dangerous injury behind the eardrum has not occurred. Fortunately, these more severe episodes are far less frequent.
Enjoy a healthy and active summer!
Mark W. Clarkson, MD
Raleigh ENT, Head & Neck Surgery
Otitis externa (“swimmer’s ear”), is easily the most frequently seen ENT problem related to water activities. It accounts for numerous office visits in a specialty ENT practice, as well as in primary care offices and urgent care centers. Pain in the ear (often quite severe) with blockage and often drainage are hallmarks of this problem. The ear is often exquisitely sensitive to pressure or pulling on the visible outside portion of the ear. While this condition often responds well to antibiotic eardrops, especially when discovered early in its course, it can occasionally be difficult to resolve and may require careful cleaning with an ENT specialist employing a microscope. It is essentially a localized infection in and on the skin of the ear canal, and it can involve bacteria or fungi. Rarely, additional preventive measures may be recommended, such as preventive drops or earplugs, but that is not routinely required.
With diving, body surfing and high-speed activities such as water skiing, traumatic water injuries (especially to the ear drum) can occur, and we see and treat them regularly. The surface of a body of water (pool, lake or ocean) can effectively “slap” the ear when someone lands wrong, especially at greater speeds or from greater heights, and send a pressure wave toward the eardrum, which can injure it. This does not always produce a perforation or hole in the eardrum, but often it does. If an injury of this type is associated with lingering alteration of hearing, pain or drainage beyond 24 hours, it is wise to be seen by an ENT specialist for a careful examination of the ears, often including an audiogram. The vast majority of injured eardrums will heal on their own and do not require any treatment; however, the drum will occasionally require attention at the time of injury to avoid failed healing and a bigger procedure later.
A similar blow to the ear with associated significant dizziness can represent a far more serious condition requiring immediate attention. While mild disorientation and brief dizziness may seem normal after wiping out on a wakeboard or with similar incidents, any severe and persistent dizziness should be evaluated as promptly as possible, to be certain a potentially dangerous injury behind the eardrum has not occurred. Fortunately, these more severe episodes are far less frequent.
Enjoy a healthy and active summer!
Mark W. Clarkson, MD
Raleigh ENT, Head & Neck Surgery
Wednesday, April 20, 2011
CT Scan
At Raleigh ENT we strive to provide excellent care. We also know that our patients are busy and appreciate convenience. We are pleased to be able to offer in office CT (CAT) scans for evaluation of the sinuses.
What is a CT scan?
CT scanning, sometimes called CAT scanning, is a noninvasive medical test that helps physicians diagnose and treat medical conditions. CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body.
X-rays are not needed for all patients, and your doctor will suggest what is appropriate when you are in for your visit. However, if a CT scan is needed, it can often be done during your visit.
When is a CT scan needed?
For example, sometimes a patient has been suffering with sinusitis for months. The primary care physician has provided appropriate treatment, yet nothing seems to work. After talking to her and examining her, her physician at Raleigh ENT decides more information is needed. A CT scan can be done to show all of the sinuses and nasal passages. Results are available within minutes and can be reviewed with you in the office. Perhaps the sinuses are free of infection and alternative diagnoses like allergies or migraines can be considered. Perhaps she has polyps or some other blockage that needs to be addressed. Or maybe chronic sinusitis is found and more antibiotics or surgery are needed.
This convenient test (when appropriate) can help you and your doctor make the most informed decision about treatment.
Does it hurt?
No. The scanning takes less than five minutes. We can accommodate children, adults, and older patients. We use advanced technology (Siemens CARE dose) to deliver maximum image quality with minimized radiation doses.
What is a CT scan?
CT scanning, sometimes called CAT scanning, is a noninvasive medical test that helps physicians diagnose and treat medical conditions. CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body.
X-rays are not needed for all patients, and your doctor will suggest what is appropriate when you are in for your visit. However, if a CT scan is needed, it can often be done during your visit.
When is a CT scan needed?
For example, sometimes a patient has been suffering with sinusitis for months. The primary care physician has provided appropriate treatment, yet nothing seems to work. After talking to her and examining her, her physician at Raleigh ENT decides more information is needed. A CT scan can be done to show all of the sinuses and nasal passages. Results are available within minutes and can be reviewed with you in the office. Perhaps the sinuses are free of infection and alternative diagnoses like allergies or migraines can be considered. Perhaps she has polyps or some other blockage that needs to be addressed. Or maybe chronic sinusitis is found and more antibiotics or surgery are needed.
This convenient test (when appropriate) can help you and your doctor make the most informed decision about treatment.
Does it hurt?
No. The scanning takes less than five minutes. We can accommodate children, adults, and older patients. We use advanced technology (Siemens CARE dose) to deliver maximum image quality with minimized radiation doses.
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