Preventing Otitis Media

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 20-23 ◽  
Author(s):  
G. Scott Giebink
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Protein Conjugate ◽  
Recurrent Acute Otitis Media ◽  
Prevalent Disease ◽  
The Common

Recurrent acute otitis media (AOM) is an extremely prevalent disease in young children. Epidemiologic associations suggest that primary prevention or reduction of AOM frequency may be achieved with breast-feeding during infancy, elimination of household tobacco smoking, and use of small rather than large day-care arrangements for infants and toddlers. Secondary antimicrobial prophylaxis with amoxicillin or sulfisoxazole reduces the frequency of recurrent AOM by about 50%, but it does not appear to reduce the duration of otitis media with effusion (OME). Tympanostomy tube insertion is not as effective as amoxicillin in reducing AOM frequency in children without OME. Adenoidectomy appears to be warranted for children who develop recurrent AOM after extrusion of tubes. Vaccines against the common bacteria and viruses causing AOM hold the greatest promise of preventing AOM and blocking the sequence of pathologic events leading to chronic OME and middle ear sequelae. The greatest progress has been made recently with pneumococcal protein conjugate vaccines, and clinical testing is in progress.

Efficacy of antimicrobial prophylaxis and of tympanostomy tube insertion for prevention of recurrent acute otitis media

1992 ◽  
Vol 11 (4) ◽  
pp. 278-285 ◽  
Author(s):  
MARGARETHA L. CASSELBRANT ◽  
PHILLIP H. KALEIDA ◽  
HOWARD E. ROCKETTE ◽  
JACK L. PARADISE ◽  
CHARLES D. BLUESTONE ◽  
...  
Keyword(s):  
Otitis Media ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Recurrent Acute Otitis Media

Antimicrobial Prophylaxis

1994 ◽  
Vol 15 (10) ◽  
pp. 377-382
Author(s):  
Gordon E. Schutze ◽  
Richard F. Jacobs
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
Tube Placement ◽  
Common Diagnosis ◽  
Recurrent Acute Otitis Media ◽  
Immunosuppressed Patients ◽  
Potential Benefits ◽  
Micro Organisms

The issue of antimicrobial prophylaxis in preventing infections in infants and children is important in the practice of pediatrics. Children are especially prone to certain infections, and pathogens are amenable to prophylaxis. Chemoprophylaxis may be used to prevent primary disease (eg, ophthalmia neonatorum) or recurrent infections (eg, otitis media). Individuals exposed to certain micro-organisms (eg, Neisseria meningitidis) or immunosuppressed patients (eg, those who are asplenic) may benefit from prophylaxis in certain situations. The duration of chemoprophylaxis may be as short as two doses (eg, endocarditis prophylaxis) or may last a lifetime (eg, rheumatic fever prophylaxis). Questions concerning the potential benefits of antimicrobial prophylaxis are quite common, and many of the answers are controversial. Because the list of specific pathogens and conditions for prophylaxis is quite long, this review will encompass only the more common conditions encountered in a busy general pediatric practice (Table 1). Otitis Media Acute otitis media is the most common diagnosis made in children when visits to the physician are prompted by illness. For every three children who have acute otitis media with effusion, one will suffer from recurrent acute otitis media: antimicrobial prophylaxis, tympanostomy tube placement, and adenoidectomy. Of these options, only chemoprophylaxis can be managed by the primary physician.

scholarly journals Grommets - an update on common indications for tympanostomy tube placement

2017 ◽  
Vol 59 (3) ◽  
pp. 13-16
Author(s):  
Kim Outhoff
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Tube Lumen ◽  
Increased Risk

Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalize pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old.1 By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent acute AOM, and acute otitis media that persists despite antibiotic therapy.2 However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1%–6%).3 This article offers guidance for family practitioners wishing to optimize health outcomes in children potentially requiring tympanostomy tube placement.

scholarly journals Grommets – an update on common indications for tympanostomy tube placement

2020 ◽  
pp. 115-117
Author(s):  
K Outhoff
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Tube Placement ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Tube Lumen ◽  
Increased Risk

Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalise pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old. By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent AOM, and acute otitis media that persists despite antibiotic therapy. However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1–6%). This article offers guidance for family practitioners wishing to optimise health outcomes in children potentially requiring tympanostomy tube placement.

Adenoidectomy plus tympanostomy tube insertion versus adenoidectomy plus myringotomy in children with obstructive sleep apnoea syndrome

2010 ◽  
Vol 125 (3) ◽  
pp. 274-278 ◽  
Author(s):  
I M Vlastos ◽  
M Houlakis ◽  
D Kandiloros ◽  
L Manolopoulos ◽  
E Ferekidis ◽  
...  
Keyword(s):  
Otitis Media ◽  
Obstructive Sleep Apnoea ◽  
Otitis Media With Effusion ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep

AbstractObjective:To determine whether tympanostomy tube insertion has benefit, compared with simple myringotomy, in children with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome caused by adenoid hypertrophy.Methods:Fifty-two children older than three years with obstructive sleep apnoea syndrome were randomly assigned to receive either adenoidectomy plus tympanostomy tube insertion (group one, n = 25) or adenoidectomy plus myringotomy (group two, n = 27). Pre- and post-operative health-related quality of life was assessed using the otitis media-6 (OM-6) tool, and audiological outcomes were recorded six and 12 months post-operatively.Results:Group one showed better quality of life scores six months post-operatively (score difference −0.38, confidence interval −0.65 to −0.10) but not 12 months post-operatively (score difference −0.23, confidence interval −0.76 to 0.11), compared with pre-operative values. Audiological outcomes did not differ significantly at either time point, compared with pre-operative values.Conclusion:Tympanostomy tube insertion confers a short term benefit, compared with simple myringotomy, in children older than three years with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome. Further studies are necessary to identify which of these children will receive long-lasting benefit from tympanostomy tube insertion.

Antimicrobial Prophylaxis for Recurrent Acute Otitis Media

1981 ◽  
Vol 90 (3_suppl2) ◽  
pp. 53-57 ◽  
Author(s):  
Jack L. Paradise
Keyword(s):  
Otitis Media ◽  
Antimicrobial Prophylaxis ◽  
Acute Otitis Media ◽  
Management Option ◽  
Recurrent Acute Otitis Media

Antimicrobial prophylaxis for children who have frequently recurring, severe episodes of acute otitis media appears to constitute a reasonable management option, even though it is not yet clear whether the advantages outweigh the disadvantages and risks. It remains for well-designed and well-executed studies that extend over relatively long periods to indicate whether this approach to management is the best of the available options, and if so, which of the available drugs is preferable.

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