They are one of the top reasons children go to the doctor. The pain can be excruciating, and when they are recurrent, whole new layers of issues are added.
Ear infections can cause children to miss school, parents to miss work, and also increase the use of antibiotics. “In addition to affecting their hearing, my children were also in constant pain and not sleeping,” said Jesse Sherr, father of two boys. “Both of my sons suffered from chronic ear infections from a very early age.”
Ear tubes, or tympanostomy tubes (TT), have long been known to help mitigate this pain. In fact, they have been shown to reduce the prevalence of middle ear effusion by 32 percent in the first year and improve average hearing levels by 5 to 12 decibels, which is significant. But getting that surgery can take multiple appointments, with more antibiotics in between. Until now.
A team of physicians and staff at Lurie Children’s developed a streamlined approach to treat children with recurrent or chronic ear infections (otitis media). After reviewing processes to see how this treatment timeline could be tightened, a team of physician champions from the Division of Otolaryngology - Head & Neck Surgery, and the Department of Anesthesiology, as well as representatives from clinical informatics and patient services, among others, met to create the work flow for same-day surgery. In addition, the team also developed a series of established clinical criteria, where the children aged 9 months to 12 years are evaluated, and if they qualify, they can be scheduled for surgery on the same day. Over the last year, the number of same-day ear tube surgeries has increased by more than 30%.
“While my wife and I were apprehensive about putting a one-year-old under general anesthesia, the staff at Lurie Children’s did an excellent job of walking us through all that was to occur and making sure we were comfortable with everything, “ said Jesse. “Being able to get everything done within one day was great. We were out of the hospital before nap time.”
“Delay in treatment for children with ongoing fluid in their ears can have lasting effects, leading to lengthier periods of time with reduced hearing,” said Kathleen Billings, MD, pediatric otolaryngologist at Lurie Children’s. “Our same-day-surgery addresses this.”
Based on the American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines, a child meets criteria for indication of Bilateral Myringotomy and Tympanostomy Tube Placement (BMT) after one of the following:
Once referred from a pediatrician, and confirmed as a candidate for surgery, the child will be scheduled. During that appointment, the child will be evaluated by an Ear Nose and Throat (ENT) surgeon and possibly an audiologist. After the evaluations, and if surgery is deemed necessary, it will be done that same day. Most patients leave within one to two hours following the procedure.
“After the procedures both boys slept much better,” said Jesse. “They had consistently better moods and most important were pain-free.”
“This program helps improve both access and efficiency of care, shortening the wait time for qualifying patients from diagnosis to treatment,” said Dr. Billings. “This can help reduce the time a patient suffers from the illness and can lead to a better quality of life for the child, which is our ultimate goal.”