I have been researching this for the past week or two, along with alternatives. When I was about 18 months old, I went through the same thing. My pediatrician wanted tubes to be a very very last resort, but recommended that my parents take me to an ENT to get an opinion. Of course, the ENT wanted to put tubes in my ears. The Ped told my parents that he didn't think that tubes were necessary, that ENTs always go immediately for the tubes because it's very lucrative, and that we should see a different ENT. We saw that one, same thing. My Dr. told him that he wanted him to lance my ears first and see if that worked before we went the tube route. Apparently, that pissed the ENT off, so he ended up lancing my ears right then without any anesthesia. (Talk about pissed parents, they still get all worked up just talking about it) But it worked! Never really had problems after that.
The problem with a myringotomy (lancing the eardrum) is that it is a very temporary solution. They make a tiny incision in the eardrum to relieve pressure from the fluid buildup. (According to Wikipedia) The difference is that, instead of then sticking an itty bitty tube in that incision to keep it open and allow ventilation, you leave it as is and then in a few days the incision heals. My first thought was to request this only because we're getting into the warmer (okay, okay, HOTTER) months where we're less likely to have ear infections, so a temporary solution makes sense.
Of course, seeing the ENT made me all the more confused. I was fully prepared for the tube talk, and this doctor totally knew a sucker when he saw one. We weighed both options, and decided to sleep on it. BUT in the meantime, Will has started his 5th round of antibiotics. He's back on Augmentin which was the one that totally tore up his poor tush last time. That was the one that helped us discover the confusing mess that is a little boy's yeast infection. WHAT? Yes, for 2 days we thought that he had a really awful diaper rash. Turns out? Yeast infection. Surprise! On his butt! You know what you use for it? Athlete's foot cream. Good to know. You'd better believe that I tucked that little golden nugget of info away for next time he gets fire butt. As if I needed to be any more confused about his nether regions...
Anyway, so after talking to other parents whose children have had tubes, it really does seem like the best option. (Like I said. Sucker.) But, I can't keep making this poor kid miserable on more antibiotics, plus right now he really needs for his ears to be well since he's starting to talk more and develop language skills.