II. Indications: Tympanostomy Tube for age 6 months to 12 years

  1. Bilateral otitits media with effusion for 3 months or more with documented hearing deficit (>25 decibels)
  2. Refractory Otitis Media
  3. Recurrent Otitis Media and persistent effusion at evaluation for Tympanostomy Tube placement
    1. Three or more episodes in 6 months or
    2. Four or more episodes in 1 year

III. Efficacy: Persistent Serous Otitis

  1. Hearing improves in short-term
  2. At 18 months, hearing same as with watchful waiting
  3. Rovers (2005) Arch Dis Child 90:480-5 [PubMed]

IV. Adverse Effects

  1. Long-term Tympanic Membrane abnormalities
    1. May result in longterm reduced hearing
    2. Stenstrom (2005) Arch Pediatr Adolesc Med 159(12): 1151-6 [PubMed]

V. Management: Otitis Media with patent Tympanostomy Tubes

  1. Only Topical Antibiotics are needed if Tympanostomy Tubes are patent
  2. Topical, non-ototoxic antibiotic options
    1. Ciprofloxacin with Hydrocortisone (Cipro HC Otic) 3 drops twice daily for 7-10 days
    2. Ofloxacin (Floxin Otic) 5 drops (10 drops if over age 12) twice daily for 7-10 days

VI. Management: Swimming

  1. Ear plugs, head bands, or swimming avoidance is not required for those with Tympanostomy Tubes

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Ontology: Tympanostomy (C0087123)

Definition (NCI) Surgical incision into the eardrum.
Concepts Therapeutic or Preventive Procedure (T061)
MSH D008876
ICD9 20.0
ICD10 309
SnomedCT 148932003, 23354000, 265049001, 172677000, 397862008, 397760009
English Tympanostomies, Middle ear paracentesis, myringotomy (treatment), myringotomy, Incision of Eardrum, Tympanostomy, tympanocentesis, tympanostomy, tympanotomy, myringotomies, Tympanic memb. operat., Grommet procedure ear, Myringotomy (procedure), Myringotomy, Tympanotomy, Myringostomy, Tympanostomy (procedure), Tympanotomy (procedure)
Italian Miringotomia, Timpanostomia, Drenaggio trans-timpanico
Japanese 鼓膜切開, コマクセッカイ
Czech Myringotomie
French Myringotomie, Tympanostomie, Tympanotomie, Myringostomie
Hungarian Myringotomia
Norwegian Tympanostomi
Spanish miringostomía, miringotomía, timpanostomía (procedimiento), timpanostomía, timpanotomía (procedimiento), timpanotomía, Miringotomía
Portuguese Miringotomia
Dutch myringotomie
German Myringotomie