Are tympanostomy tubes indicated for recurrent acute otitis media?

Abstract

For children with recurrent acute otitis media (here defined as 3 or more episodes in 6 months, or 4 or more in a year), tympanostomy tubes are indicated if middle -ear effusion is present. Tubes reduce the frequency of recurrent acute otitis media by 2 to 3 episodes per year in these patients (strength of recommendation [SOR]: A; based on randomized controlled trials). Further benefits include improved quality of life for both child and caregiver and greater parental satisfaction (SOR: B; based on trials that included patients with recurrent acute otitis media or otitis media with effusion). Tympanostomy tubes do not decrease the number of recurrent acute otitis media episodes in children without middle-ear effusion (SOR: A, based on randomized controlled trials). These children run the risk of adverse outcomes of tube placement, including transient or recurrent otorrhea, tympanosclerosis, focal atrophy, perforation, and cholesteatoma (SOR: A; based on meta-analysis).