Treatment of chronic otitis media with effusion: results of tympanostomy tubes

Abstract

Insertion of tympanostomy tubes to provide prolonged aeration and drainage of the tympanum in cases of chronic secretory otitis media has become the most commonly performed operation in children. To investigate the therapeutic efficacy of current treatments of chronic secretory otitis media, the authors undertook a randomized clinical trial with four treatment arms: myringotomy alone, tympanostomy tubes, adenoidectomy and myringotomy, and the combination of adenoidectomy and tympanostomy tubes. This report describes the preliminary (one-year) outcome in the group of children who were treated with tympanostomy tubes. The observed average differences between the myringotomy and tympanostomy tube groups were small, with the exception of one variable (time to first recurrence). Although the clinical importance of these differences remains to be established, the authors believe they are substantial enough to justify continued use of tympanostomy tubes in the primary surgical therapy of chronic secretory otitis media, when medical therapy and observation indicate the need for drainage to improve hearing or correct anatomic deformities of the tympanum.