Need for Tympanostomy Tubes in Children With Recurrent Acute Otitis Media Without Middle Ear Effusion.

{"article_title":"Need for Tympanostomy Tubes in Children With Recurrent Acute Otitis Media Without Middle Ear Effusion.","author":"Clark A, Forner D, Noel CW, Corsten G, Hong P","journal_title":"Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery","issn":"1097-6817","isbn":"","publication_date":"2023 Sep","volume":"169","issue":"3","first_page":"694","page_count":"","accession_number":"36939487","doi":"10.1002\/ohn.299","publisher":"Wiley","doctype":"Journal Article","subjects":"Otitis Media with Effusion surgery; Otitis Media surgery; Otolaryngology; Child; Humans; Infant; Child, Preschool; Middle Ear Ventilation; Recurrence; Chronic Disease","interest_area":["Pediatric Medicine"," ENT"," Internal\/Family Medicine"],"abstract":"Objective: Children with recurrent acute otitis media (RAOM) presenting without middle ear effusion (MEE) do not meet indications for surgical intervention as outlined by Clinical Practice Guidelines (CPGs). The objective of this study was to determine which patients presenting with RAOM without MEE ultimately received tympanostomy tubes. Study Design: Case series. Setting: Single academic pediatric otolaryngology clinic. Methods: Children (0-12 years) presenting with RAOM and no MEE were identified from October 2017 to December 2019. As per CPGs, no surgery was offered initially. Patients were given a semiurgent return appointment should they experience another suspected otitis media episode. If MEE was observed, tympanostomy tube insertion was offered. Patients were followed for 1-year following enrollment. Results: One-hundred and twenty-four patients were included. The median age was 3.15 years old (interquartile range: 4.10). Seventy-five (60%) patients did not require additional follow-up and thus did not require tympanostomy tubes. Forty-nine (40%) patients were seen again; of these, 11 patients received tympanostomy tubes. Therefore, of patients presenting with no MEE, 91% did not require tympanostomy tubes. Patients who had surgery were younger on initial assessment than those who did not (mean difference 2.68 years, 95% confidence interval: 2.14-3.23). Conclusion: This study demonstrates the practical effect of adhering to CPGs for RAOM and suggests that many children may not require tympanostomy tube placement within the 1st year after the consultation if they did not initially present with MEE. \ufffd 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=36939487&authtype=shib&custid=ns346513","isPdfLink":true,"isSAML":false,"additionalInfo":{"Authored_By":"Clark A, Forner D, Noel CW, Corsten G, Hong P","Journal_Info":"Publisher: Wiley Country of Publication: England NLM ID: 8508176 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6817 (Electronic) Linking ISSN: 01945998 NLM ISO Abbreviation: Otolaryngol Head Neck Surg Subsets: MEDLINE","Publication_Type":"Journal Article","Published_Date":"2023-09-01","Source":"Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2023 Sep; Vol. 169 (3), pp. 694-700. Date of Electronic Publication: 2023 Feb 05.","Languages":"English","Electronic_ISSN":"1097-6817","MeSH_Terms":"Otitis Media with Effusion*\/surgery , Otitis Media*\/surgery , Otolaryngology*, Child ; Humans ; Infant ; Child, Preschool ; Middle Ear Ventilation ; Recurrence ; Chronic Disease","Subjects":"Child, Humans, Infant, Child, Preschool, Middle Ear Ventilation, Recurrence, Chronic Disease, Otitis Media with Effusion surgery, Otitis Media surgery, Otolaryngology","Title_Abbreviations":"Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery","Volume":"169"},"header":{"DbId":"mdl","DbLabel":"MEDLINE Ultimate","An":"36939487","RelevancyScore":"923","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"923.23828125"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=36939487&authtype=shib&custid=ns346513&group=main&profile=eds","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=mdl&AN=36939487&authtype=shib&custid=ns346513&group=main&profile=eds"}