Early Ear Tubes Don't Make Kids Smarter

NEW YORK (Reuters Health) - Immediate placement of ear tubes in children with fluid build-up doesn't improve their IQ or other developmental outcomes compared with waiting several months to see if the fluid disappears.

Hearing plays an important role in childhood development. Therefore, it was thought that by improving hearing early on, prompt placement of tympanostomy or "T tubes" in kids with recurrent bouts of otitis media could lead to better developmental outcomes later in childhood.

In an earlier study, Dr. Jack L. Paradise, from the Children's Hospital of Pittsburgh, and colleagues had shown that prompt T tube insertion did not improve developmental outcomes at 3 or 4 years of age. The present findings expand on this by showing that outcomes at 6 years of age, the age at which most children begin school, are not improved either.

The new study, which is reported in The New England Journal of Medicine, involved 6350 healthy infants who were regularly evaluated for fluid build-up in the middle ear. A total of 429 children, younger than 3 years of age, were found to have persistent fluid and were randomly selected to receive T tubes promptly or 9 months later if the fluid was still present.

By 6 years of age, 85 percent of subjects in the immediate-insertion group and 41 percent in the delayed-insertion group had received T tubes, the report indicates.

Using 30 different measures, including a standard IQ test and the number of different words test, the researchers were unable to detect any significant developmental differences between children in the two groups.

"These data, together with the risks posed by the insertion of tubes, provide clear support" for waiting to see if the fluid build-up disappears on its own after several months, the authors conclude. They emphasize, however, that this advice only applies to otherwise healthy children; kids with inherent developmental problems and other health issues may benefit more from immediate tube placement. SOURCE: The New England Journal of Medicine, August 11, 2005.