N FE B RU A RY 2014 Otitis Media Tympanostomy Tubes and Clinical Practice Guidelines from 2013 Key Action Statement Discussion Points Y offer tympanostomy tubes for T his is c ID: 952290
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AAO-HNS BULLETI N ||||||||||||||| FE B RU A RY 2014 Otitis Media, Tympanostomy Tubes, and Clinical Practice Guidelines from 2013 Key Action Statement Discussion Points Y offer tympanostomy tubes for T his is considered an “option” for treatment of recurrent AOM.Most AOM guidelines before 2013 did not contain statements about tympa-AAO-HNSF Clinical T ympanostomy T ubes in Children2Clinicians SHO UL D NO T perform tympanostomy tube insertion in children with a history of recurrent acute AOM did not have middle ear effusions at trial entry and did have a favorable -Clinicians SHO UL Trials that did not exclude children with middle ear effusion suggest a modest reduction in number of episodes of AOM after tympanostomy tubes. T ympanostomy T ubes in Children2 Clinicians SHO UL D NO T perform tympanostomy tube insertion in children with a single episode of OM E Short-term effusions can occur after viral infection or AOM and often resolve UL D offer tympanostomy bilateral tube insertion to children with bilateral OM E for three months or longer AND documented hearing Clinicians MA Y perform tympanostomy tube insertion in children with unilateral or bilateral OM E for three months or longer (chronic OM E ) AND symptoms that are likely attributable to OM E that include, but are not limited to, balance (vestibular) problems, poor school Otitis media with effusion can be associated with symptoms and conditions Clinicians MA Y perform tympanostomy tube insertion in at-risk children with unilateral or bilateral OM E that T ubes are an option for “at risk” children with OM E and type B tympanograms.Who are these “at risk” children? E delays, visual impairment, cleft palate, other developmental delays.TYMPANOSTOMY T ympanostomy T ubes in Children2Clinicians SHO UL D prescribe topical antibiotic eardrops only, without oral antibiotics, for children T may require systemic antibiotics when otorrhea occurs after tympanostomy R outine, prophylactic water precautions SHO UL D NO T be encouraged for children with tympanostomy tubes.-tions (lake swimming, deep diving, history of recurrent otorrhea, head dunking I Surgery Foundation (AAO-HNSF) David E. Tunkel, MDChair, AAO-HNS Pediatric Director of Pediatric Otolaryngology, E ), including treatment with tympanostomy I n the table below we compare