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Is aspiration of middle ear effusions prior to ventilation tube insertion really necessary?
1Department of Otolaryngology, St. Bartholomew's Hospital, London, United Kingdom.
Insights
Routine middle ear aspiration before ventilation tube insertion is not necessary for children with middle ear effusions. This prospective randomized trial found no significant differences in outcomes between aspirated and non-aspirated ears, simplifying the surgical procedure.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Middle ear effusions are common in children.
- Ventilation tube insertion is a standard treatment.
- The necessity of pre-insertion middle ear aspiration is debated.
Purpose of the Study:
- To evaluate the clinical necessity of middle ear aspiration before ventilation tube insertion.
- To compare outcomes in children undergoing myringotomy with and without prior aspiration.
Main Methods:
- Prospective, double-blind, randomized trial.
- 55 children with bilateral middle ear effusions.
- Clinical, pure tone, and impedance audiometry assessments.
- Bilateral myringotomy with random ear aspiration before ventilation tube insertion.
Main Results:
- No significant differences in postoperative outcomes up to three months.
- Both aspirated and non-aspirated middle ears showed similar results.
- The procedure was evaluated using objective audiological measures.
Conclusions:
- Routine middle ear aspiration prior to ventilation tube insertion is not necessary.
- Simplifying the surgical procedure may be possible.
- Further research could explore long-term outcomes.
Abstract:
A prospective double blind randomized trial of 55 children undergoing myringotomy and insertion of ventilation tubes for bilateral middle ear effusions was undertaken. The aim of the study was to assess the need for clearance of the middle ear by aspiration prior to the insertion of ventilation tubes. The day before surgery the children were assessed by clinical examination, pure tone audiometry and impedance audiometry. At the time of surgery each child underwent bilateral myringotomy, with aspiration of the right or left ear only on a randomly allocated basis. Standard ventilation tubes were then inserted. Postoperative evaluation up to three months following surgery showed no significant differences between the aspirated and the non-aspirated middle ears. We conclude that routine evacuation of the middle ear prior to ventilation tube insertion is not necessary.