Tympanostomy tube insertion for otitis media in children a systematic review

This SBU report reviews the scientific evidence for tympanostomy tube insertion in the tympanic membrane (eardrum) of children with recurrent acute otitis media (inflammation of the middle ear) or long-term episodes of secretory otitis media (with fluid accumulation in the middle ear). Although thes...

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Bibliographic Details
Corporate Author: Statens beredning för medicinsk utvärdering (Sweden)
Other Authors: Hellström, S. (Contributor)
Format: eBook
Language:English
Published: Stockholm Swedish Council on Health Technology Assessment (SBU) 2008, 2008
Series:SBU yellow report
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
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100 1 |a Hellström, S.  |e [contributor] 
245 0 0 |a Tympanostomy tube insertion for otitis media in children  |h Elektronische Ressource  |b a systematic review  |c project group: Sten Hellström (chair), Susanna Axelsson (assistant project director), Kristina Bengtsson Boström, Ingemar Eckerlund, Anita Groth, Kickan Håkanson (project assistant), Finn Jörgensen, Jonas Lindblom, Agneta Pettersson (project director), Marie Ryding, Inger Uhlén ; scientific reviewers: Ingrid Augustsson, Claes Hemlin, Ulf Persson, Karin Stenfeldt ; English translation: Ken Schubert 
246 3 1 |a Summary and conclusions of the SBU report 
260 |a Stockholm  |b Swedish Council on Health Technology Assessment (SBU)  |c 2008, 2008 
300 |a 1 PDF file (29 pages)  |b illustrations 
653 |a Child 
653 |a Otitis Media / surgery 
653 |a Middle Ear Ventilation / methods 
710 2 |a Statens beredning för medicinsk utvärdering (Sweden) 
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989 |b NCBI  |a National Center for Biotechnology Information 
490 0 |a SBU yellow report 
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520 |a This SBU report reviews the scientific evidence for tympanostomy tube insertion in the tympanic membrane (eardrum) of children with recurrent acute otitis media (inflammation of the middle ear) or long-term episodes of secretory otitis media (with fluid accumulation in the middle ear). Although these conditions eventually heal, approximately 10,000 Swedish children a year have such severe problems due to episodes of pain, reduced quality of life or hearing loss that tympanostomy tube insertion is considered to be warranted. Conclusions The systematic literature review, along with a survey of clinical practice, generated the following conclusions.1. The scientific evidence for tympanostomy tube insertion in children with recurrent acute otitis media is insufficient. Given that more than 2,000 Swedish children a year receive the treatment for this indication, reliable studies are needed as soon as possible.2.  
520 |a Routine removal of tubes that are not spontaneously discharged has not been shown to reduce the risk of complications.5. Bathing and swimming do not increase the risk of tympanostomy tube otorrhoea (discharge) (limited scientific evidence). Preventive measures such as earplugs or eardrops when bathing or swimming have little or no effect (moderately strong scientific evidence).6. The scientific evidence is insufficient to determine whether tympanostomy tube insertion is cost-effective for recurrent acute otitis media or secretory otitis media 
520 |a Tympanostomy tube insertion for long-term secretory otitis media improves hearing (strong scientific evidence) and quality of life (moderately strong scientific evidence) for at least 9 months. Treating children with this indication in such a manner is justified if they have objectively verified hearing loss and accompanying reduction in quality of life. Forms that have been tested for children with diseases of the ear can be used to assess quality of life.3. Adenoidectomy improves hearing at 6-month follow-up as effectively as tympanostomy tube insertion in children with long-term secretory otitis media (limited scientific evidence). Combining tympanostomy tube insertion with adenoidectomy does not lead to further hearing improvement at 3-month follow up (moderately strong scientific evidence).4. Suctioning out fluid in the middle ear in combination with tympanostomy tube insertion does not extend functionality or reduce obstruction of the tube.