Treatment
Perioperative Education
Î 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. (R-C)
Acute TTO
Î Clinicians should prescribe topical antibiotic eardrops only, without oral
antibiotics, for children with uncomplicated acute TTO. (S-B)
Water Precautions
Î Clinicians should NOT encourage routine, prophylactic water precautions
(use of earplugs, headbands; avoidance of swimming or water sports) for
children with tympanostomy tubes. (R-B)
Figure 4. AOM without a tympanostomy tube (left) and with a tube (right).
Figure 4. Acute Otitis
AOM without a tympanostomy tube (le) and with a tube (right). Without a tube, the tympanic
membrane is bulging and inflamed, which causes pain and sometimes rupture.
Reproduced with permission: Rosenfeld RM. A Parent's Guide to Ear Tubes. Hamilton, Ontario, Canada:
BC Decker; 2005.
Table 4. Comparison of AOM with and without a
Tympanostomy Tube
Issue AOM without a Tube AOM with a Tube
Ear pain Mild to severe None, unless skin irritated
or tube occluded
Drainage from the ear canal
(otorrhea)
No, unless eardrum ruptures Yes, unless tube obstructed
Duration of MEE aer infection Can last weeks or months Usually resolves promptly
Needs oral antibiotics Oen Rarely
Needs antibiotic eardrops No benefit Oen
Risk of eardrum rupture Yes No, unless tube obstructed
Risk of suppurative complications Rare Exceedingly rare
