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Tympanostomy Tubes 2022

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2 Key Points ➤ Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. ➤ Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. • All these conditions are encompassed by the term otitis media (middle ear inflammation), which is second in frequency only to acute upper respiratory infection (URI) as the most common illness diagnosed in children by health care professionals. ➤ When children receive surgery for OME (Table 1), insertion of tympanostomy tubes is the preferred initial procedure, with candidacy dependent primarily on hearing status, associated symptoms, and the child's developmental risk. ➤ Risks and potential adverse events of tympanostomy tube insertion are related to both general anesthesia, usually required for the procedure, and the effects of the tympanostomy tube on the tympanic membrane and middle ear. ➤ When making clinical decisions, the risks of tube insertion must be balanced against the risks of chronic OME, recurrent otitis media, or both conditions, which include suppurative complications, damage to the tympanic membrane, adverse effects of antibiotics, and potential developmental sequelae of the mild to moderate hearing loss that is often associated with middle ear effusion. Table 1. Abbreviations and Definitions of Common Terms Term Definition Myringotomy A surgical procedure in which an incision is made in the tympanic membrane for the purpose of draining fluid from the middle ear space or providing short-term ventilation. Tympanostomy tube insertion Surgical placement of a tube through a myringotomy incision for purposes of temporary middle ear ventilation. Tympanostomy tubes generally last several months to several years, depending on tube design and placement location in the tympanic membrane. Synonyms include ventilation tubes, pressure equalization (PE) tubes, grommets (UK), and bilateral myringotomy and tubes (BMT). Otitis media with effusion (OME) e presence of fluid in the middle ear without signs or symptoms of acute otitis media (AOM). Chronic OME OME persisting for 3 months or longer from the date of onset (if known) or from the date of diagnosis (if onset unknown).

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