Which children would benefit most from tympanostomy tubes (grommets)? A personal evidence-based review

Summary Otitis media with effusion (OME) is a common condition in young children. OME causes some hearing loss, and can cause permanent changes in the tympanic membrane as well as other symptoms. In most cases OME is of short duration. As long-lasting bilateral OME for decades has been associated wi...

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Bibliographic Details
Published in:International journal of pediatric otorhinolaryngology 2008-06, Vol.72 (6), p.731-736
Main Author: Lous, Jørgen
Format: Article
Language:English
Subjects:
Adenoidectomy
Child
Child Development
Children at risk
Cognition
Decision Making
Hearing Loss - prevention & control
Humans
Middle Ear Ventilation
Otitis media with effusion
Otitis Media with Effusion - complications
Otitis Media with Effusion - surgery
Otolaryngology
Pediatrics
Tympanostomy tubes
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Summary:Summary Otitis media with effusion (OME) is a common condition in young children. OME causes some hearing loss, and can cause permanent changes in the tympanic membrane as well as other symptoms. In most cases OME is of short duration. As long-lasting bilateral OME for decades has been associated with delayed cognitive and language development, parents and ENT specialists have a positive attitude towards treatment with tympanostomy tubes (TT). Method This personal evidence-based review is build on own observations and research combined with newer studies and guidelines. Results The review argues for a relatively restrictive treatment policy concerning the use of TT in children with OME without signs or symptoms of impaired social or linguistic function. Conclusion Six months with bilateral OME and significant hearing loss should be present before treatment with TT in otherwise healthy children. At the moment we have no evidence for the subgroups of children excluded from the RCTs, i.e. children with speech/language delays, behaviour and learning problems, or syndromes. Clinicians will need to make their own decisions regarding treatment of such children. The situation just now is that some children are over-treated and some are under-treated. There is an urgent need for prospective cohort studies and randomised studies on children with long-lasting OME in an attempt to characterise the children who would benefit most from TT.
ISSN:0165-5876
1872-8464
DOI:10.1016/j.ijporl.2008.01.025