instruction: hello doctor my daughter is years old with a tube in her left ear and a perforation in her right ear the doctor does not want to fix the perforated ear until the tube falls out of the left ear and is healthy for a year in the meantime it is suggested that a hearing aid be used until the perforation surgery does this sound like a normal course of action and will ear perforation surgery improve the situation
output: hello we shall do the ear perforation surgery only when we are sure that eustachian tube ventilation to the middle ear is normal and not hampered by any reason the functioning of the eustachian tube is indicated by the successful falling off of the ventilation tube the grommet the falling off indicates that middle ear pressures are getting maintained by the natural eustachian tube usually kids of this age have some remnant adenoids which causes tubal obstruction causing recurrent ear issues like in your kid usually the adenoids regress by this age if they don then the kid will have symptoms of mouth breathing snoring teeth crowding and protrusion and other signs of adenoids facies if these issues are there then before we attempt ear surgery we will have to remove the adenoids and tonsils because the source of ear infection is adenoids tonsils otherwise we can wait for a while until the natural eustachian tubes function well and then we can repair the eardrum we would need to do an adenoids ray to check for the adenoids size meanwhile hearing aid is the best option because you cannot risk your child not hearing properly at this age as it would adversely affect his speech and development for any queries on this matter please revert back to me