Contemporary Guidelines for Tympanostomy Tube Placement

Abstract

Although tympanostomy tube placement has been one of the most common surgical procedures in children in the USA for many years, clinical practice guidelines were not developed until recently. In 2013, the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) published a clinical practice guideline based on an extensive literature review to address specific indications for surgery. These clinical practice guidelines focus primarily on chronic otitis media with effusion and recurrent acute otitis media and provide an evidence-based framework for decision-making strategies. Although a useful tool to assist in clinical decision-making, it is important to keep in mind that individual patient considerations and circumstances must also be taken into account when making treatment decisions. Otherwise, healthy children with minimal risk of developmental delays should be given a generous observation period prior to offering tympanostomy tube placement; higher-risk children should undergo more prompt surgical intervention.