5
Table 2. Summary of Guideline Key Action Statements (KAS)
(cont'd)
Statement Action Grade
9. Tympanostomy
Tubes in At-Risk
Children
Clinicians may perform tympanostomy
tube insertion in at-risk children with
unilateral or bilateral OME that is likely
to persist as reflected by a type B (flat)
tympanogram or a documented effusion
for 3 months or longer.
Option
10. Long-term
Tubes
e clinician should not place long-term
tubes as initial surgery for children who
meet criteria for tube insertion unless there
is a specific reason based on an anticipated
need for prolonged middle ear ventilation
beyond that of a short-term tube.
Recommendation
(against)
11. Adjuvant
Adenoidectomy
Clinicians may perform adenoidectomy
as an adjunct to tympanostomy tube
insertion for children with symptoms
directly related to the adenoids (adenoid
infection or nasal obstruction) OR
in children aged 4 years or older to
potentially reduce future incidence of
recurrent otitis media or the need for
repeat tube insertion.
Option
12. Perioperative
Education
In the perioperative period, clinicians
should educate caregivers of children
with tympanostomy tubes regarding
the expected duration of tube function,
recommended follow-up schedule, and
detection of complications.
Recommendation
13. Perioperative
Ear Drops
Clinicians should not routinely prescribe
postoperative antibiotic ear drops aer
tympanostomy tube placement.
Recommendation
(against)
14. Acute
Tympanostomy
Tube Otorrhea
Clinicians should prescribe topical
antibiotic ear drops only, without oral
antibiotics, for children with uncomplicated
acute tympanostomy tube otorrhea.
Strong
recommendation
15. Water
Precautions
Clinicians should not encourage routine,
prophylactic water precautions (use of
earplugs or headbands, avoidance of
swimming or water sports) for children
with tympanostomy tubes.
Recommendation
(against)
16. Follow-up e surgeon or designee should examine
the ears of a child within 3 months of
tympanostomy tube insertion AND
should educate families regarding the need
for routine, periodic follow-up to examine
the ears until the tubes extrude.
Strong
recommendation
