Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media

Casselbrant, Margaretha L.; Kaleida, Phillip H.; Rockette, Howard E.; Paradise, Jack L.; Bluestone, Charles D.; Kurs‐Lasky, Marcia; Nozza, Robert J.; Wald, Ellen R.

doi:10.1097/00006454-199204000-00004

Cited by 182 publications

(148 citation statements)

References 0 publications

Supporting

Mentioning

140

Contrasting

Unclassified

Order By: Relevance

“…The mean time of VT permanence (12, 13 months) was similar to that reported by Collete et al 10 (13.8 months) and Casselbrant et al 11 (12 months). Given that the tube we used is a short duration VT, of dual reel-like setup, with estimated permanence of 6-18 months, we understand that the results we found were as expected.…”

Section: Discussionsupporting

confidence: 88%

Seqüelas de tubos de ventilação em crianças com otite média com efusão: um seguimento de três anos

Pereira¹,

Pereira

Costa

2005

Rev. Bras. Otorrinolaringol.

View full text Add to dashboard Cite

Tympanost omy tube (TT) insertion is one of the most frequently performed procedures in otolaryngology. Otorrhea, tympanosclerosis, retraction, perforation, and cholesteatoma are complications reported in the literature after its application. Aim: To determine the incidence and the type of TT insertion sequelae/complications in children presenting with recurrent otitis media and chronic otitis media with effusion undergoing myringotomy and tube placement. Study Design: prospective cohort study. Material and Method: A total of 75 children (150 ears) aged 11 months to 10 years were regularly followed up for up to 38 months after TT insertion. Results: Incidence of sequelae/complications: otorrhea -47.3% of the ears; perforation -2.1%; retractions -39.7%; tympanosclerosis -23.3%. Average length of stay: 12.13 months. Mean age at initial tube placement of children not requiring a second set of tubes = 35.9 months and mean age at initial tube insertion of children requiring an additional set of tubes = 25.6 months (P=0.04). TT stayed longer in the ears that had more episodes of otorrhea (P=0.01). TT insertion with adenoidectomy was associated with a smaller number of otorrhea episodes (P=0.02) Conclusions: Otorrhea was the most frequently found complication. TT placement with adenoidectomy was associated with fewer otorrhea episodes. TT extruded later in those ears that had more episodes of otorrhea. Younger age at the time of the initial tube placement is associated with higher incidence of additional tube placement. One in six patients will probably require a second set of ventilation tubes.

show abstract

Section: Discussionsupporting

confidence: 88%

Seqüelas de tubos de ventilação em crianças com otite média com efusão: um seguimento de três anos

Pereira¹,

Pereira

Costa

2005

Rev. Bras. Otorrinolaringol.

View full text Add to dashboard Cite

show abstract

“…203,204 One study randomly assigned children with recurrent AOM to groups receiving placebo, amoxicillin prophylaxis, or tympanostomy tubes and followed them for 2 years. 205 Although prophylactic antibiotics reduced the rate of AOM, no difference in number of episodes of AOM was noted between the tympanostomy tube group and the placebo group over 2 years. A Cochrane review of studies of tympanostomy tubes for recurrent AOM analyzed 2 studies 204,206 that met inclusion criteria and found that tympanostomy tubes reduced the number of episodes of AOM by 1.5 episodes in the 6 months after surgery.…”

Section: Surgery For Recurrent Aommentioning

confidence: 85%

The Diagnosis and Management of Acute Otitis Media

Tunkel

Rosenfeld²,

Sevilla³

et al. 2013

Pediatrics

1,060

832

View full text Add to dashboard Cite

This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM.In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations.The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships.The practice guideline underwent comprehensive peer review before formal approval by the AAP.This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem. Pediatrics 2013;131:e964-e999

show abstract

“…When 2 episodes of otitis media occur within 1 month, it may be difficult to distinguish recurrence of AOM (ie, a new episode) from persistent otitis media (ie, relapse) Recurrent AOM Three or more well-documented and separate AOM episodes in the past 6 months or at least 4 well-documented and separate AOM episodes in the past 12 months with at least 1 in the past 6 months 9 Middle ear effusion (MEE) Fluid in the middle ear from any cause but most often from OME and during, or after, an episode of AOM Conductive hearing loss (CHL)…”

Section: Term Definitionmentioning

confidence: 99%

Clinical Practice Guideline: Tympanostomy Tubes in Children

Rosenfeld

Schwartz

Pynnonen

et al. 2013

Otolaryngol.--head neck surg.

337

134

View full text Add to dashboard Cite

Objective. Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. Despite the frequency of tympanostomy tube insertion, there are currently no clinical practice guidelines in the United States that address specific indications for surgery. This guideline is intended for any clinician involved in managing children, aged 6 months to 12 years, with tympanostomy tubes or being considered for tympanostomy tubes in any care setting, as an intervention for otitis media of any type.Purpose. The primary purpose of this clinical practice guideline is to provide clinicians with evidence-based recommendations on patient selection and surgical indications for and management of tympanostomy tubes in children. The development group broadly discussed indications for tube placement, perioperative management, care of children with indwelling tubes, and outcomes of tympanostomy tube surgery. Given the lack of current published guidance on surgical indications, the group focused on situations in which tube insertion would be optional, recommended, or not recommended. Additional emphasis was placed on opportunities for quality improvement, particularly regarding shared decision making and care of children with existing tubes.Action Statements. The development group made a strong recommendation that clinicians should prescribe topical antibiotic eardrops only, without oral antibiotics, for children with uncomplicated acute tympanostomy tube otorrhea. The panel made recommendations that (1) clinicians should not perform tympanostomy tube insertion in children with a single episode of otitis media with effusion (OME) of less than 3 months' duration; (2) clinicians should obtain an age-appropriate hearing test if OME persists for 3 months or longer (chronic OME) or prior to surgery when a child becomes a candidate for tympanostomy tube insertion; (3) clinicians should offer bilateral tympanostomy tube insertion to children with bilateral OME for 3 months or longer (chronic OME) and documented hearing difficulties; (4) clinicians should reevaluate, at 3-to 6-month intervals, children with chronic OME who did not receive tympanostomy tubes until the effusion is no longer present, significant hearing loss is detected, or structural abnormalities of the tympanic membrane or middle ear are suspected; (5) clinicians should not perform tympanostomy tube insertion in children with recurrent acute otitis media (AOM) who do not have middle ear effusion in either ear at the time of assessment for tube candidacy; (6) clinicians should offer bilateral tympanostomy tube insertion to children with recurrent AOM who have unilateral or bilateral middle ear effusion at the time of assessment for tube candidacy; (7) clinicians should determine if a child with recurrent AOM or with OME of any duration is at increased risk for sp...

show abstract

Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media

Cited by 182 publications

References 0 publications

Seqüelas de tubos de ventilação em crianças com otite média com efusão: um seguimento de três anos

Seqüelas de tubos de ventilação em crianças com otite média com efusão: um seguimento de três anos

The Diagnosis and Management of Acute Otitis Media

Clinical Practice Guideline: Tympanostomy Tubes in Children

Contact Info

Product

Resources

About