tympanostomy tube

^[1]^[2]^[3]^[4]^[5]

Introduction

A tiny tube, usually of metal or plastic & about 0.5 cm long, that can be inserted after myringotomy to ventilate the middle ear.

substantial hearing loss or structural abnormality in children with persistent middle ear effusion^[3]

otherwise healthy children with persistent middle ear effusion but without hearing loss or structural abnormality^[3]

otorrhea
recurrent acute otitis media
- cholesteoma
up to 60% of children with tympanostomy tubes develop otorrhea secondary to otitis media

antibiotic-glucocorticoid eardrops are superior to oral antibiotics or observation in children with otorrhea secondary to otitis media^[5]

Does not improve developmental outcomes at age 6 when placed for persistent middle ear effusion^[4]

↑ nlmpubs.nlm.nih.gov/hstat/ahcpr/
↑ Journal Watch 24(4):35, 2004 Roland PS et al, Pediatrics 113:e40, 2004 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14702493
Roland PS et al http://pediatrics.aappublications.org/cgi/content/full/113/1/e40
↑ ^3.0 ^3.1 ^3.2 Paradise JL, Campbell TF, Dollaghan CA, Feldman HM, Bernard BS, Colborn DK, Rockette HE, Janosky JE, Pitcairn DL, Kurs-Lasky M, Sabo DL, Smith CG. Developmental outcomes after early or delayed insertion of tympanostomy tubes. N Engl J Med. 2005 Aug 11;353(6):576-86. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16093466
↑ ^4.0 ^4.1 Paradise JL, Campbell TF, Dollaghan CA, Feldman HM, Bernard BS, Colborn DK, Rockette HE, Janosky JE, Pitcairn DL, Kurs-Lasky M, Sabo DL, Smith CG. Developmental outcomes after early or delayed insertion of tympanostomy tubes. N Engl J Med. 2005 Aug 11;353(6):576-86. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16093466
↑ ^5.0 ^5.1 van Dongen TMA et al. Cost-effectiveness of treatment of acute otorrhea in children with tympanostomy tubes. Pediatrics 2015 May 1; 135:e1182 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25896832