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Related Experiment Videos

Interventions for ear discharge associated with grommets (ventilation tubes).

L Vaile1, T Williamson, A Waddell

  • 1NHS House, Child Health Department, Newbridge Hill, Bath, UK, BA1 3QE. Louise.Vaile@banes-pct.nhs.uk

The Cochrane Database of Systematic Reviews
|April 21, 2006
PubMed
Summary

Limited evidence suggests oral amoxicillin clavulanate may effectively manage ear discharge after grommet insertion. However, more research is urgently needed to compare oral versus topical antibiotics and assess risks like ototoxicity.

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Evidence-Based Medicine

Background:

  • Grommet insertion (ventilation tubes) is a common pediatric surgery.
  • Postoperative ear discharge (otorrhoea) is the most frequent complication (10-50%).
  • Treatment varies, with UK surgeons favoring topical antibiotics/steroids, while GPs often opt for systemic antibiotics due to ototoxicity concerns.

Purpose of the Study:

  • To determine the most effective non-surgical management for ear discharge in patients with grommets.
  • To evaluate the risks (e.g., ototoxicity) and benefits of non-surgical treatments.

Main Methods:

  • Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to February 2005.
  • Included randomized controlled trials comparing treatments for grommet-related ear discharge.

Related Experiment Videos

  • Primary outcome was the duration of discharge; studies were critically appraised.

    • Main Results:

    • Very limited high-quality evidence was found; a meta-analysis was not possible.
    • One study showed oral amoxicillin clavulanate significantly reduced discharge duration compared to placebo (NNT=2.5), but involved daily aural toilet.
    • No significant benefit was observed for steroids or antibiotic-steroid combinations.

    Conclusions:

    • The review could not identify the most effective intervention or assess associated risks.
    • Urgent research is needed on oral versus topical antibiotic effectiveness for this condition.
    • Clinicians must weigh potential benefits against risks like side effects and antibiotic resistance.