Which child would benefit most from having ear tubes placed?

• A. A 2-month-old who has had one ear infection.
• B. A 2-year-old who has had five previous ear infections.
• C. A 3-year-old whose sibling has had four ear infections.
• D. A 7-year-old who has had two ear infections this year.

Answer: (B)

Tympanostomy tubes are considered when a child has recurrent acute otitis media or persistent middle-ear fluid that affects hearing. Recurrent acute otitis media is usually defined as three or more episodes within six months or four within a year, with at least one episode in the last six months. The child with five prior ear infections clearly meets this recurrent criterion, making tubes the best option to reduce future infections and protect hearing.

The other scenarios don’t meet that threshold: a 2-month-old with only one infection isn’t recurrent and is younger than the typical window for surgery unless there are other strong reasons; a child whose situation is described only by a sibling’s infections has no actual disease burden in this child; and a 7-year-old with two infections this year has not reached the recurrence level that prompts tube placement.