Should your toddler have ear tubes inserted to help prevent ear infections? The inner ear is full of air and is connected to the outside through the eustachian tube that opens into the back of your mouth. Young children have narrow eustachian tubes that can close and fill with fluid that causes ear pressure and pain. If your doctor sees fluid causing the ear drum to bulge outward, he knows that the eustachian tube is closed and often prescribes antibiotics and a cortisone-type nasal spray. Antihistamines do not open eustachian tubes. Doctors sometimes remove tonsils and adenoids or give allergy injections, but these treatments have an extraordinarily high failure rate.

Since the eustachian tube enlarges as a child grows, the tube usually opens by itself in time and it is rarely necessary to perform surgery. However, if the doctor feels that fluid in the drum can interfere with a child's hearing or school work or that permanent damage in possible, it is reasonable to relieve this pressure by punching a hole in the ear drum and inserting a tube to keep it open. Research shows that the buildup of fluid in the inner ear is probably caused by inactive cilia, the small hairs that line the eustachian tube and sweep fluid toward the mouth. Erythromycin antibiotics can stimulate the cilia, remove fluid from the inner ear and help to relieve the discomfort.

Gabe Mirkin, M.D.

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in Sports Medicine and three other specialties.

Dr. Mirkin's daily features on fitness have been heard on CBS Radio News stations since the 1970's. He has written 16 books including The Sportsmedicine Book, the best-selling book on the subject that has been translated into many languages. His latest book is The Healthy Heart Miracle, published by HarperCollins.

Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. A Boston native, Dr. Mirkin did his residency at the Massachusetts General Hospital. He has served as a Teaching Fellow at Johns Hopkins Medical School, Assistant Professor at the University of Maryland, and Associate Clinical Professor in Pediatrics at the Georgetown University School of Medicine. He has run more than forty marathons and is now a serious tandem bicycle rider with his wife, nutritionist Diana Mirkin.