Healio: Ear tubes may be unnecessary in some cases, study finds
By Rose Weldon
Guidelines for ear infections in young children may lead to unnecessary tympanostomy tube placement, according to a study published in Pediatrics.
The study found that recurrent cases of acute otitis media occur in a narrow “window of susceptibility” and that many tube placements likely occur after this window has passed. In such cases, “the cessation of [acute otitis media] is attributed to the surgery when, in fact, our data [suggest] the [window of susceptibility] may have ended and the child would have experienced an end to [the infections] with patience and watchful waiting,” the authors wrote.
National guidelines endorsed by the AAP and American Academy of Otolaryngology suggest that a child becomes a candidate for tubes following three ear infections in 6 months, or four ear infections in 12 months.
In an accompanying commentary, pediatric infectious disease physicians Rana E. El Feghaly, MD, MSCI, and Mary Anne Jackson, MD, from Children’s Mercy Kansas City and the University of Missouri-Kansas City School of Medicine, said the study could help clinicians determine children who may need earlier referral for tube placement. But they also noted some remaining questions.
“Would the data be replicated in a patient population that is not predominantly white, insured, and with very low smoking exposure, a controllable risk factor for [acute otitis media]?” they asked. “With the decrease in vaccination rates that we are currently witnessing, will the epidemiology of [acute otitis media] shift yet again?
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