Dale W Steele1,2,3,4, Gaelen P Adam5, Mengyang Di5, Christopher H Halladay5, Ethan M Balk5,2, Thomas A Trikalinos5,2. 1. Evidence-based Practice Center, Center for Evidence Synthesis in Health, dale_steele@brown.edu. 2. Department of Health Services, Policy and Practice, School of Public Health. 3. Department of Emergency Medicine, Section of Pediatrics-Hasbro Children's Hospital, and. 4. Department of Pediatrics, Alpert Medical School, Brown University, Providence, Rhode Island. 5. Evidence-based Practice Center, Center for Evidence Synthesis in Health.
Abstract
CONTEXT: Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. OBJECTIVES: The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. DATA SOURCES: Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles were independently screened by 2 investigators. DATA EXTRACTION: A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. RESULTS: Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% credible interval: -14.0 to -3.4) at 1 to 3 months and 0.0 (95% credible interval: -4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. LIMITATIONS: Sparse evidence is available, applicable only to otherwise healthy children. CONCLUSIONS: Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events.
CONTEXT: Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. OBJECTIVES: The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. DATA SOURCES: Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. STUDY SELECTION: Abstracts and full-text articles were independently screened by 2 investigators. DATA EXTRACTION: A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. RESULTS:Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% credible interval: -14.0 to -3.4) at 1 to 3 months and 0.0 (95% credible interval: -4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. LIMITATIONS: Sparse evidence is available, applicable only to otherwise healthy children. CONCLUSIONS: Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events.
Authors: Hwan Ho Lee; Anthony Chin; Kwang Pak; Stephen I Wasserman; Arwa Kurabi; Allen F Ryan Journal: Exp Cell Res Date: 2019-12-13 Impact factor: 3.905
Authors: Peter P Sun; Jungeun Won; Gabrielle Choo-Kang; Shouyan Li; Wenyuan Chen; Guillermo L Monroy; Eric J Chaney; Stephen A Boppart; J Gary Eden; Thanh H Nguyen Journal: NPJ Biofilms Microbiomes Date: 2021-06-02 Impact factor: 7.290
Authors: Rustin G Kashani; Marcel C Młyńczak; David Zarabanda; Paola Solis-Pazmino; David M Huland; Iram N Ahmad; Surya P Singh; Tulio A Valdez Journal: Sci Rep Date: 2021-06-15 Impact factor: 4.379