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The Effect of Ventilating Tubes in Young Children with Recurrent Acute Otitis Media: an Update of the Literature

  • Pediatrics: Otitis Media in Children (A Hermansson, Section Editor)
  • Published:
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Abstract

Purpose of Review

Ventilating tube treatment (VT) is a common surgical procedure in preschool children. Twenty to fifty percent of children treated with VT suffer from recurrent acute otitis media (RAOM). The aim of this review is to update current knowledge on the topic.

Recent Findings

There is still controversy regarding the use of VT for children with RAOM. So far, only six randomized trials have been published. From the limited data pool, it seems that children with RAOM treated with VT experienced less time with acute otitis media and experienced less recurrence compared to controls. However, no difference in quality of life was found between subgroups in one trial.

Summary

Children with RAOM seem to benefit from VT on objective parameters, especially if middle ear effusion is present in between acute episodes. There is a need for more high quality evidence on the subjective domains such as disease severity and quality of life.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Heidemann CH, Lauridsen HH, Kjeldsen AD, et al. Quality-of-life differences among diagnostic subgroups of children receiving ventilating tubes for otitis media. Otolaryngol Head Neck Surg. 2015;153:636–43.

    Article  PubMed  Google Scholar 

  2. Boruk M, Lee P, Faynzilbert Y, et al. Caregiver well-being and child quality of life. Otolaryngol Head Neck Surg. 2007;136:159–68.

    Article  PubMed  Google Scholar 

  3. Brouwer CN, Rovers MM, Maille AR, et al. The impact of recurrent acute otitis media on the quality of life of children and their caregivers. Clin Otolaryngol. 2005;30:258–65.

    Article  CAS  PubMed  Google Scholar 

  4. Heidemann CH, Lauridsen HH, Kjeldsen AD, et al. Caregiver quality of life and daily functioning in relation to ventilating tube treatment. Otolaryngol Head Neck Surg. 2014;151:341–7.

    Article  PubMed  Google Scholar 

  5. Armstrong BW. A new treatment for chronic secretory otitis media. AMA Arch Otolaryngol. 1954;59:653–4.

    Article  CAS  PubMed  Google Scholar 

  6. Hellstrom S, Groth A, Jorgensen F, et al. Ventilation tube treatment: a systematic review of the literature. Otolaryngol Head Neck Surg. 2011;145:383–95.

    Article  PubMed  Google Scholar 

  7. Keyhani S, Kleinman LC, Rothschild M, et al. Clinical characteristics of New York City children who received tympanostomy tubes in 2002. Pediatrics. 2008;121:e24–33.

    Article  PubMed  Google Scholar 

  8. Todberg T, Koch A, Andersson M, et al. Incidence of otitis media in a contemporary Danish National Birth Cohort. PLoS One. 2014;9:e111732.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chow Y, Wabnitz DA, Ling J. Quality of life outcomes after ventilating tube insertion for otitis media in an Australian population. Int J Pediatr Otorhinolaryngol. 2007;71:1543–7.

    Article  PubMed  Google Scholar 

  10. •• Heidemann CH, Lous J, Berg J, et al. Danish guidelines on management of otitis media in preschool children. Int J Pediatr Otorhinolaryngol. 2016;87:154–63. One of only two published guidelines on VT treatment for RAOM. This guideline is based on existing RCT studies.

  11. •• Rosenfeld RM, Schwartz SR, Pynnonen MA, et al. Clinical practice guideline: Tympanostomy tubes in children. Otolaryngol Head Neck Surg. 2013;149:1–35. The first guideline to include VT treatment for RAOM.

  12. Cheong KH, Hussain SS. Management of recurrent acute otitis media in children: systematic review of the effect of different interventions on otitis media recurrence, recurrence frequency and total recurrence time. J Laryngol Otol. 2012;126:874–85.

    Article  CAS  PubMed  Google Scholar 

  13. Lous J, Ryborg CT, Thomsen JL. A systematic review of the effect of tympanostomy tubes in children with recurrent acute otitis media. Int J Pediatr Otorhinolaryngol. 2011;75:1058–61.

    Article  PubMed  Google Scholar 

  14. McDonald S, Langton Hewer CD, Nunez DA. Grommets (ventilation tubes) for recurrent acute otitis media in children. Cochrane Database Syst Rev 2008;CD004741.

  15. Kujala T, Alho OP, Kristo A, et al. Recurrent acute otitis media detracts from health-related quality of life. J Laryngol Otol. 2017:1–10.

  16. Kujala T, Alho OP, Luotonen J, et al. Tympanostomy with and without adenoidectomy for the prevention of recurrences of acute otitis media: a randomized controlled trial. Pediatr Infect Dis J. 2012;31:565–9.

    Article  PubMed  Google Scholar 

  17. Kujala T, Alho OP, Kristo A, et al. Quality of life after surgery for recurrent otitis media in a randomized controlled trial. Pediatr Infect Dis J. 2014;33:715–9.

    Article  PubMed  Google Scholar 

  18. Gebhart DE. Tympanostomy tubes in the otitis media prone child. Laryngoscope. 1981;91:849–66.

    Article  CAS  PubMed  Google Scholar 

  19. El Sayed Y. Treatment of reccurent acute otitis media chemoprophylaxis versus ventilation tubes. Aus J Otolaryngol. 1996;2:352–5.

    Google Scholar 

  20. Casselbrant ML, Kaleida PH, Rockette HE, et al. Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media: results of a randomized clinical trial. Pediatr Infect Dis J. 1992;11:278–86.

    Article  CAS  PubMed  Google Scholar 

  21. Gonzalez C, Arnold JE, Woody EA, et al. Prevention of recurrent acute otitis media: chemoprophylaxis versus tympanostomy tubes. Laryngoscope. 1986;96:1330–4.

    Article  CAS  PubMed  Google Scholar 

  22. Le CT, Freeman DW, Fireman BH. Evaluation of ventilating tubes and myringotomy in the treatment of recurrent or persistent otitis media. Pediatr Infect Dis J. 1991;10:2–11.

    Article  CAS  PubMed  Google Scholar 

  23. Higgins JP, Altman DG, Gotzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hoberman A, Preciado DA. Efficacy of tympanostomy tubes for children with recurrent acute otitis media. https://clinicaltrials.gov/ct2/show/NCT02567825 2017.

  25. Demant MN, Jensen RG, Jakobsen JC, et al. The effects of ventilation tubes versus no ventilation tubes for recurrent acute otitis media or chronic otitis media with effusion in 9 to 36 month old Greenlandic children, the SIUTIT trial: study protocol for a randomized controlled trial. Trials. 2017;18:30.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Richards M, Giannoni C. Quality-of-life outcomes after surgical intervention for otitis media. Arch Otolaryngol Head Neck Surg. 2002;128:776–82.

    Article  PubMed  Google Scholar 

  27. Rosenfeld RM, Bhaya MH, Bower CM, et al. Impact of tympanostomy tubes on child quality of life. Arch Otolaryngol Head Neck Surg. 2000;126:585–92.

    Article  CAS  PubMed  Google Scholar 

  28. Witsell DL, Stewart MG, Monsell EM, et al. The Cooperative Outcomes Group for ENT: a multicenter prospective cohort study on the outcomes of tympanostomy tubes for children with otitis media. Otolaryngol Head Neck Surg. 2005;132:180–8.

    Article  PubMed  Google Scholar 

  29. Rosenfeld RM, Jang DW, Tarashansky K. Tympanostomy tube outcomes in children at-risk and not at-risk for developmental delays. Int J Pediatr Otorhinolaryngol. 2011;75:190–5.

    Article  PubMed  Google Scholar 

  30. Heidemann CH, Lous J, Berg J, et al. National clinical guideline for ventilating tube treatment—diagnosis and indications for treatment in children aged 0–5 years [Danish]. https://www.sst.dk/da/udgivelser/2015/mellemoerebetaendelse-og-oeredraen 2015.

  31. Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope. 2003;113:1645–57.

    Article  PubMed  Google Scholar 

  32. Casselbrant ML, Kaleida PH, Rockette HE, et al. In reference to what is the role of tympanostomy tubes in the treatment of recurrent acute otitis media? Laryngoscope. 2013;123:E127.

    Article  PubMed  Google Scholar 

  33. Heidemann CH, Godballe C, Kjeldsen AD, et al. The Otitis Media-6 questionnaire: psychometric properties with emphasis on factor structure and interpretability. Health Qual Life Outcomes. 2013;11:201.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kubba H, Swan IR, Gatehouse S. How appropriate is the OM6 as a discriminative instrument in children with otitis media? Arch Otolaryngol Head Neck Surg. 2004;130:705–9.

    Article  PubMed  Google Scholar 

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Correspondence to C. H. Heidemann.

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Conflict of Interest

Christian Heidemann, Preben Homøe, and Jørgen Lous declare that they have no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Pediatrics: Otitis Media in Children

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Heidemann, C.H., Homøe, P. & Lous, J. The Effect of Ventilating Tubes in Young Children with Recurrent Acute Otitis Media: an Update of the Literature. Curr Otorhinolaryngol Rep 5, 108–114 (2017). https://doi.org/10.1007/s40136-017-0150-8

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  • DOI: https://doi.org/10.1007/s40136-017-0150-8

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