New Information About Tympanostomy Tubes
Tom Parker
Managing Director of PC Werth, United Kingdom
By Tom Parker
Ear tubes – also known as tympanostomy tubes or grommets – have long been a common solution to chronic ear problems in children. In fact, myringotomy with tube insertion is the most commonly performed outpatient surgery on children in the United States (more than 670,000 undergo the procedure every year).
The function of these tiny hollow tubes is to aerate the middle ear and relieve excessive fluid build-up, and they are widely accepted as the best available treatment for children with ear problems. However, recent research suggests that not all children benefit from the procedure, and it’s vitally important for clear guidelines to be put in place to identify only the most suitable candidates for ear tubes. The American Academy of Otolaryngology – Head and Neck Surgery has just addressed this issue by publishing the United States’ first evidence-based guideline on tympanostomy tubes.
Richard Rosenfeld, the paediatric ENT specialist and chair of the guideline panel, says that the guidelines have been designed to “identify children who shouldn’t get tubes and those who should” and provide advice on “the best way to care for the tubes if they do get them.”
According to these guidelines, many children affected by fluid build-up in the middle ear tend to get better on their own without the need for tympanostomy tubes. If the fluid build-up (known as otitis media with effusion, or OME) persists for three months or more, the patient should undergo an age-appropriate hearing test before ear tubes are recommended if necessary.
Children who have frequent ear infections, but do not have middle ear effusion should not be automatically considered suitable candidates for the tubes. “Watchful waiting” is a better solution than an unnecessary tympanostomy procedure, says Rosenfeld. Complications are rare, but naturally prevention is better than cure.
In addition, children with ear tubes are often cautioned by physicians to stay out of the water or never to swim without earplugs. The new guidelines have revealed these precautions to be unnecessary. “You don’t need to worry,” Rosenfeld tells parents. “They can swim, bathe, jump in the pool, go to the beach. You don’t need to keep the water out of their ears.”
These guidelines should offer plenty of encouraging news for patients as well as solid guidelines for medical practitioners.
