What are the AAO-HNSF guidelines for the use of tympanostomy tubes in the treatment of acute otitis media (AOM)?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) offers the following guidance on the use of tympanostomy tube insertion for children with AOM [41] :

  • Tympanostomy tube insertion should not be performed in children with recurrent AOM who do not have middle ear effusion (MEE) in either ear at the time of assessment for tube candidacy
  • Bilateral tympanostomy tube insertion should be performed in children who have unilateral or bilateral MEE at the time of assessment for tube candidacy
  • Educate caregivers of children with tympanostomy tubes regarding the expected duration of tube function, recommended follow-up schedule, and detection of complications
  • Clinicians should prescribe topical antibiotic eardrops only, without oral antibiotics, for children with uncomplicated acute tympanostomy tube otorrhea
  • Encourage routine, prophylactic water precautions (use of earplugs or headbands; avoidance of swimming or water sports) for children with tympanostomy tubes

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