Second tympanostomy tube placement in children with recurrent acute otitis media

2017 ◽  
Vol 128 (6) ◽  
pp. 1476-1479 ◽  
Author(s):  
Phillip Huyett ◽  
Joshua J. Sturm ◽  
Amber D. Shaffer ◽  
Dennis J. Kitsko ◽  
David H. Chi
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Recurrent Acute Otitis Media

Tympanostomy Tube Placement vs Medical Management for Recurrent Acute Otitis Media in TRICARE-Insured Children

2017 ◽  
Vol 157 (5) ◽  
pp. 867-873 ◽  
Author(s):  
Nikhila Raol ◽  
Meesha Sharma ◽  
Emily F. Boss ◽  
Wei Jiang ◽  
John W. Scott ◽  
...  
Keyword(s):  
Otitis Media ◽  
Medical Management ◽  
Acute Otitis Media ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Recurrent Acute Otitis Media

Preventing Otitis Media

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 20-23 ◽  
Author(s):  
G. Scott Giebink
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Protein Conjugate ◽  
Recurrent Acute Otitis Media ◽  
Prevalent Disease ◽  
The Common

Recurrent acute otitis media (AOM) is an extremely prevalent disease in young children. Epidemiologic associations suggest that primary prevention or reduction of AOM frequency may be achieved with breast-feeding during infancy, elimination of household tobacco smoking, and use of small rather than large day-care arrangements for infants and toddlers. Secondary antimicrobial prophylaxis with amoxicillin or sulfisoxazole reduces the frequency of recurrent AOM by about 50%, but it does not appear to reduce the duration of otitis media with effusion (OME). Tympanostomy tube insertion is not as effective as amoxicillin in reducing AOM frequency in children without OME. Adenoidectomy appears to be warranted for children who develop recurrent AOM after extrusion of tubes. Vaccines against the common bacteria and viruses causing AOM hold the greatest promise of preventing AOM and blocking the sequence of pathologic events leading to chronic OME and middle ear sequelae. The greatest progress has been made recently with pneumococcal protein conjugate vaccines, and clinical testing is in progress.

scholarly journals Tympanostomy Tube Selection: A Review of the Evidence

2016 ◽  
Vol 7 (1) ◽  
pp. 17-22
Author(s):  
Ho Sandra ◽  
David J Kay
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
The United States ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Middle Ear Effusion ◽  
Surgeon Experience ◽  
Ear Effusion

ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

scholarly journals Tympanostomy Tubes—A Visual Guide for the Young Otolaryngologist

2020 ◽  
Vol 99 (1_suppl) ◽  
pp. 8S-14S
Author(s):  
Glenn Isaacson
Keyword(s):  
Clinical Practice ◽  
Correct Diagnosis ◽  
Acute Otitis Media ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Shared Experience ◽  
Tube Removal ◽  
Recurrent Acute Otitis Media ◽  
Tympanostomy Tubes ◽  
The Common

Objectives: To illustrate some of the common dilemmas in tympanostomy tube care and describe time-tested ways to address them. Methods: Computerized literature review. Results: Issues including the correct diagnosis of recurrent acute otitis media, tympanostomy tube types and techniques for tube placement, management of tube clogging and otorrhea, and methods for tube removal and patching are illustrated. Conclusions: Tympanostomy tube placement is the most common surgery performed in children requiring general anesthesia. While some elements of tympanostomy tube care have been addressed in clinical studies, much of clinical practice is guided by shared experience.

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

1992 ◽  
Vol 11 (4) ◽  
pp. 278-285 ◽  
Author(s):  
MARGARETHA L. CASSELBRANT ◽  
PHILLIP H. KALEIDA ◽  
HOWARD E. ROCKETTE ◽  
JACK L. PARADISE ◽  
CHARLES D. BLUESTONE ◽  
...  
Keyword(s):  
Otitis Media ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Recurrent Acute Otitis Media

Antimicrobial Prophylaxis

1994 ◽  
Vol 15 (10) ◽  
pp. 377-382
Author(s):  
Gordon E. Schutze ◽  
Richard F. Jacobs
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
Tube Placement ◽  
Common Diagnosis ◽  
Recurrent Acute Otitis Media ◽  
Immunosuppressed Patients ◽  
Potential Benefits ◽  
Micro Organisms

The issue of antimicrobial prophylaxis in preventing infections in infants and children is important in the practice of pediatrics. Children are especially prone to certain infections, and pathogens are amenable to prophylaxis. Chemoprophylaxis may be used to prevent primary disease (eg, ophthalmia neonatorum) or recurrent infections (eg, otitis media). Individuals exposed to certain micro-organisms (eg, Neisseria meningitidis) or immunosuppressed patients (eg, those who are asplenic) may benefit from prophylaxis in certain situations. The duration of chemoprophylaxis may be as short as two doses (eg, endocarditis prophylaxis) or may last a lifetime (eg, rheumatic fever prophylaxis). Questions concerning the potential benefits of antimicrobial prophylaxis are quite common, and many of the answers are controversial. Because the list of specific pathogens and conditions for prophylaxis is quite long, this review will encompass only the more common conditions encountered in a busy general pediatric practice (Table 1). Otitis Media Acute otitis media is the most common diagnosis made in children when visits to the physician are prompted by illness. For every three children who have acute otitis media with effusion, one will suffer from recurrent acute otitis media: antimicrobial prophylaxis, tympanostomy tube placement, and adenoidectomy. Of these options, only chemoprophylaxis can be managed by the primary physician.

scholarly journals Grommets - an update on common indications for tympanostomy tube placement

2017 ◽  
Vol 59 (3) ◽  
pp. 13-16
Author(s):  
Kim Outhoff
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Tube Lumen ◽  
Increased Risk

Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalize pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old.1 By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent acute AOM, and acute otitis media that persists despite antibiotic therapy.2 However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1%–6%).3 This article offers guidance for family practitioners wishing to optimize health outcomes in children potentially requiring tympanostomy tube placement.

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