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Many Children May Not Meet Criteria for Ear Tubes

In cohort, half of children didn't have effusion for recommended three months before tympanostomy

THURSDAY, Jan. 10 (HealthDay News) -- Many children undergoing tympanostomy tube insertion may not meet the criteria for the procedure recommended by published guidelines, according to a retrospective study published in the January issue of Pediatrics.

Salomeh Keyhani, M.D., of the Mount Sinai School of Medicine in New York City, and colleagues reviewed data from 682 children (mean age 3.8 years) who received tympanostomy tubes in five New York City area hospitals in 2002.

The clinical practice guideline that applied at the time was from 1994 from the Agency for Healthcare Policy and Research. For otitis media with effusion, the guideline recommended waiting for tubes for otherwise healthy children until a bilateral effusion lasted at least three to four months. However, the investigators found that 50 percent of children had surgery before having three months of cumulative effusion in the previous year.

"(An) explanation for the variations observed may be the impact of otitis media on family life. As described in other contexts, social stressors or anxiety regarding otitis media might lead parents to make erroneous judgments about how threatening the condition is to the health of their child. If this is the case, then pediatricians can serve their patients by taking a leadership role that includes comforting these families regarding the generally benign nature of their patients' otitis media. By helping to alleviate these anxieties, pediatricians may promote a more balanced discussion of optimal clinical management," the authors write.

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