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Clinical Practice Guideline: Tympanostomy Tubes in Children

Clinical Practice Guideline: Tympanostomy Tubes in Children


The guideline was published as a supplement in the July 2013 issue of Otolaryngology—Head and Neck Surgery.

The purpose of this clinical practice guideline is to provide clinicians with evidence-based recommendations on patient selection and surgical indications for and management of tympanostomy tubes in children. This guideline is intended for any clinician involved in managing children, aged 6 months to 12 years, with tympanostomy tubes or children being considered for tympanostomy tubes in any care setting as an intervention for otitis media of any type.

Leadership: Richard M. Rosenfeld, MD, MPH (Chair); Melissa A. Pynnonen, MD, MSc (Assistant Chair); David E. Tunkel, MD (Assistant Chair); Seth R. Schwartz, MD, MPH (Methodologist)

Guideline Development Group: Jeffrey S. Fichera, PA-C; Alison M. Grimes, AuD; Jesse M. Hackell, MD, FAAP; Melody F .Harrison, PhD; Helen Haskell, MA; David S. Haynes, MD, FACS; Tae W. Kim, MD; Denis C. Lafreniere, MD; Katie LeBlanc, MTS, MA; Wendy L. Mackey, APRN, BC; James L. Netterville, MD; Mary E. Pipan, MD; Nikhila P. Raol, MD; Kenneth G. Schellhase, MD, MPH


For Physicians
For Patients

In 2012 the ABIM Foundation launched Choosing Wisely® with a goal of advancing a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures.

Choosing Wisely centers around conversations between providers and patients informed by the evidence-based recommendations.

Access the AAO-HNSF Choosing Wisely List of 10 Things Providers and Patients Should Question

Oral antibiotics have significant adverse effects and do not provide adequate coverage of the bacteria that cause most episodes; in contrast, topically administered products do provide coverage for these organisms. Avoidance of oral antibiotics can reduce the spread of antibiotic resistance and the risk of opportunistic infections.

Ear fluid of short duration is likely to resolve spontaneously. The child should be monitored to ensure resolution of the fluild. In children with comorbid conditions or speech delay, earlier tube placement may be appropriate.