Related Experiment Video

Updated: Jul 8, 2026

Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique
07:06

Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique

Published on: May 23, 2021

Medical decision analysis: indications for tympanostomy tubes in RAOM by age at first episode

Thomas S Higgins1, Steven J McCabe, Jeffrey M Bumpous

  • 1Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA 23507, USA. higgints@evms.edu

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|January 1, 2008
PubMed

Insights

Tympanostomy tubes (TT) are recommended sooner for children experiencing their first acute otitis media (AOM) episode at a very young age. This approach addresses the increased risk of recurrent AOM in this demographic.

Area of Science:

  • Pediatric Otolaryngology
  • Evidence-Based Medicine
  • Decision Analysis

Background:

  • Recurrent acute otitis media (RAOM) significantly impacts children's quality of life and healthcare utilization.
  • Management options for RAOM include short-courses of antibiotics and tympanostomy tubes (TT).
  • Age at the first episode of AOM is a critical factor in RAOM prognosis.

Purpose of the Study:

  • To compare the utility estimates of tympanostomy tubes (TT) versus short-courses of antibiotics for treating recurrent acute otitis media (RAOM).
  • To stratify treatment recommendations based on the age of the child at their first episode of acute otitis media (AOM).

Main Methods:

  • A formal decision analysis model was employed.
  • Utility estimates were compared between TT and antibiotic treatment strategies.
  • Recommendations were stratified by age at the first AOM episode.

Main Results:

  • The decision model recommended earlier tympanostomy tube (TT) insertion for children with an early-onset first episode of acute otitis media (AOM).
  • For children over 12 months at onset, TT were advised for 7 episodes/24 months, 5 episodes/12 months, or 3 episodes/6 months.
  • For children under 6 months at onset, TT were advised for 3 episodes/24 months or 2 episodes/6-12 months.

Conclusions:

  • Earlier tympanostomy tube (TT) intervention may be beneficial for children experiencing their first acute otitis media (AOM) episode at a very young age.
  • This age-stratified approach acknowledges the heightened risk of AOM recurrence in early-onset cases.
  • This study represents the first formal decision analysis comparing TT and antibiotics for RAOM, stratified by age at first AOM onset.
Abstract

More Related Videos

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses14:05

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses

Published on: January 23, 2017

The Microscopic Transcanal Approach in Stapes Surgery Revisited07:35

The Microscopic Transcanal Approach in Stapes Surgery Revisited

Published on: February 16, 2022

Related Concept Videos

Assessing Body Temperature - Tympanic membrane01:14

Assessing Body Temperature - Tympanic membrane

Assessing tympanic membrane temperature involves using a tympanic membrane thermometer (TMT). Here is a step-by-step guide:
Step 1: Begin by practicing good hand hygiene to prevent the transmission of microorganisms.
Step 2: Turn on the thermometer and wait until the ready sign appears on the screen to ensure accurate measurement.
Step 3: Slide the probe cover in place to prevent cross-contamination.
Step 4: Instruct the patient to tilt their head to the side for comfort and check for cerumen...
Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Chronic Pharyngitis01:23

Chronic Pharyngitis

Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...