New guidelines can lead to cheaper, more effective treatment for fluid behind the ears

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Fluid behind the ear affects nearly all children and now there are some new recommendations for treatment (Source: KPHO/KTVK) Fluid behind the ear affects nearly all children and now there are some new recommendations for treatment (Source: KPHO/KTVK)
Dr. Jerald Altman recommends skipping antibiotics for fluid behind the ear in children (Source: KPHO/KTVK) Dr. Jerald Altman recommends skipping antibiotics for fluid behind the ear in children (Source: KPHO/KTVK)
Surgery should be last resort for treat fluid behind the ear (Source: KPHO/KTVK) Surgery should be last resort for treat fluid behind the ear (Source: KPHO/KTVK)
GLENDALE, AZ (3TV/CBS 5) -

Four-year-old Wyatt Westergard was on his best behavior recently as he headed into a west Valley surgery center for what would be a quick operation to put in ear tubes. 

His mother, Lori Westergard, says it's something doctors have looked at for several years due to ear infections and hearing problems. But the final factor that led doctors to recommend the surgery was something unexpected. 

“He has recently been having behavior issues at his daycare," she said. 

And when Wyatt went in for some tests, they discovered a possible cause.

“And he passed everything for behavior," Westergard said. "However he did not pass the hearing test.”

It turned out Wyatt had fluid behind his ears, something called otitis media with effusion or OME.  

“The numbers say that before the age of 5, 90 percent of children are going to have OME, or fluid behind their ear,” Valley otolaryngologist Dr. Jerald Altman, MD, said. 

He says treating OME comes with an associated cost of about $4 billion per year.

But Altman says new recommendations endorsed by the American Academy of Family Physicians could both save money and lead to better treatment. One of the most important changes is if there is no infection, skip the antibiotics.

“Children should not be treated with antibiotics anymore, it doesn't work," Altman said. "They shouldn't be treated with antihistamines, decongestants, nasal steroids spray, oral steroids."

Doctors are now also urged to observe many patients rather than put in ear tubes to help drain the fluid.

“Because 95 percent of all children, fluid will clear up within three months,” Altman said.

This also helps doctors know when tubes would be appropriate. 

“We want to see the child when the fluid has been there for three months or longer, and if they have an associated behavioral problem, physical problem, educational problem, or they just simply are not doing well at school or hearing their parents or teacher,” Altman said.

In Wyatt's case, the fluid had been there six months and there were those behavioral problems that may well stem from not being able to hear. It took Altman less than half an hour to put in the tubes, through a small surgical opening in the ear drum. They will eventually fall out on their own.  Westergard is hoping it will help Wyatt hear and behave better.

“We are kind of hoping that we will see a change in that as well,” Westergard said.

Altman says despite the new recommendations, some doctors are still using antibiotics. He says not only does that add unnecessary costs but can also lead to the growth of drug resistant bacteria.

Copyright 2016 KPHO/KTVK (KPHO Broadcasting Corporation). All rights reserved.

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