Insertion of ventilation (tympanostomy) tubes for otitis media with effusion

doi:10.1136/bmj.a1535

Published 3 October 2008, doi:10.1136/bmj.a1535
Cite this as: BMJ 2008;337:a1535

Editorials

Insertion of ventilation (tympanostomy) tubes for otitis media with effusion

Clinical audit needs to be re-established to monitor the criteriafor intervention

The first 150 words of the full text of this article appear below.

In otitis media with effusion (secretory otitis media or glueear), ventilation tubes (tympanostomy tubes, pressure equalisationtubes, or grommets) are placed in the eardrums to improve thehearing, behaviour, and development of children. This, the commonestoperation in children worldwide has an evidence base which isperiodically scrutinised.¹ Guidelines attempt to foster stringentcriteria for the operation because in most cases otitis mediais mild and non-persistent, and the consequences of fluctuatinghearing losses for language development have been exaggeratedin the past.² In the linked study (doi:10.1136/bmj.a1607) Keyhaniand colleagues examined the clinical characteristics of childrenwith otitis media in New York who had ventilation tubes andcompared these with the recommendations of two sets of expertguidelines and a set of RAND appropriateness criteria.³ Agreementwith recommendations was very low—only 30.3% of tympanostomieswere concordant with the explicit criteria and only 7.5% wereconcordant with . . . [Full text of this article]

Mark Haggard, MRC senior scientist

¹ MRC Multicentre Otitis Media Study Group, Cambridge CB2 3EB

mph38@cam.ac.uk

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