New clinical guideline: pediatric ear tubes
A multidisciplinary clinical practice guideline that helps physicians identify children most likely to benefit from tympanostomy tubes, provide the best care before and after surgery, and improve counseling and education for parents was published in a supplement to the July edition of the journal Otolaryngology — Head and Neck Surgery. It is the first evidence-based guideline in the United States for tubes, the most common reason for outpatient surgery performed on children in the United States.
"The tympanostomy tube guideline not only helps doctors and parents identify children likely to benefit most from surgery, but importantly identifies those for whom watchful waiting may be a better option," said Richard M. Rosenfeld, MD, MPH, chair of the guideline panel.
Research shows that 667,000 tympanostomy tube procedures are performed annually on children under the age of 15. By age 3, nearly 1 in 15 children have tubes.
Despite the frequency of tympanostomy tube surgery, until now there have been no evidence-based recommendations in the United States to assist doctors in identifying the best surgical candidates and their subsequent care. The guideline, covering children aged 6 months to 12 years, was created by a panel that included a pediatric and adult otolaryngologist, otologist/neurotologist, anesthesiologist, audiologist, family physician, behavioral pediatrician, pediatrician, speech/language pathologist, advanced nurse practitioner, physician assistant, resident physician, and consumer advocates. The guideline’s authors are Richard M. Rosenfeld, MD, MPH, Seth R. Schwartz, MD, MPH, Melissa A. Pynnonen, MD, MSc, David E. Tunkel, MD, Heather M. Hussey, MPH, Jeffrey S. Fichera, PA-C, Alison M. Grimes, AuD, Jesse M. Hackell, MD, FAAP, Melody F. Harrison, PhD, Helen Haskell, MA, David S. Haynes, MD, Tae W. Kim, MD, Denis C. Lafreniere, MD, Katie LeBlanc, MTS, MA, Wendy L. Mackey, APRN, James L. Netterville, MD, Mary E. Pipan, MD, Nikhila P. Raol, MD, and Kenneth G. Schellhase, MD, MPH.
The guideline can be found at http://www.entnet.org/guide_lines/Tubes.cfm.