WITHDRAWN: Interventions for ear discharge associated with grommets (ventilation tubes)

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Evidence-Based Medicine

Background:

• Grommet insertion (ventilation or tympanostomy tubes) is a frequent pediatric surgical procedure.
• Postoperative otorrhoea (ear discharge) is the most common complication, occurring in 10-50% of cases.
• Current UK practice varies, with surgeons favoring topical treatments and GPs opting 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 for this condition.

Main Methods:

• Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to February 2005.
• Included randomized controlled trials comparing treatments for discharge in patients with grommets.
• Primary outcome was the duration of discharge; analyses focused on discharge at seven days post-treatment.

Main Results:

• Very limited high-quality evidence was found; four studies were included, preventing meta-analysis.
• One study showed oral amoxicillin clavulanate significantly reduced discharge duration compared to placebo (NNT=2.5), but included daily aural toilet, limiting generalizability.
• No significant benefits were observed for steroid treatments or antibiotic-steroid combinations.

Conclusions:

• The most effective non-surgical intervention and associated risks remain unclear due to insufficient evidence.
• Urgent research is needed on oral versus topical antibiotic effectiveness for grommet-related ear discharge.
• Clinicians must weigh potential benefits against risks like side effects and antibiotic resistance.