What is the Role of Tympanostomy Tubes in the Treatment of Recurrent Acute Otitis Media?

Background

Approximately 90% of children will experience at least one bout of acute otitis media (AOM). An infection will most commonly occur within the first two years of life, with the highest incidence between six to 12 months of age. Recurrent AOM (rAOM) is generally defined as a child having a minimum of three bouts of AOM in a six-month period or four bouts in one year. Treatment options for children with rAOM include episodic treatment with analgesics alone or antibiotics, prophylactic antibiotic therapy, or myringotomy with or without tympanostomy tube (TT) placement.

Best Practice

The American Academy of Otolaryngology–Head and Neck Surgery’s guidelines recommend TT treatment in cases of rAOM. Currently, there is limited evidence to strongly support the use of TT over medical therapy for rAOM. Given that AOM is very common in children and that TT placement is also common, a large, randomized, controlled study is needed, as is suggested by the American Academy of Pediatrics guidelines for treatment of acute otitis media. Surgical intervention should be considered as second-line treatment if medical therapy fails. Alternatively, if a child with rAOM is very symptomatic, the use of TT may improve some quality-of-life parameters. Read the full article in The Laryngoscope.