Indications for insertion of ear tubes

Otolaryngologists' perceptions of the indications for tympanostomy tube insertion in children.

Insertion of ear tubes to manage recurrent ear infections is the most common type of surgery for children in North America and Europe. However, there are only 2 (1 American and 1 British) published studies on the opinions of otolaryngologists concerning indications for inserting these tubes in children. Given that rates of myringotomy with insertion of tympanostomy tubes vary widely by region, Warren McIsaac and colleagues surveyed Ontario otolaryngologists to measure the extent of agreement on 17 potential indications for this surgery. Using 90% concordance as a definition of clinical agreement, the 121 eligible respondents agreed on only 6 of 17 factors and on the management of only 1 of 4 clinical vignettes. Given this lack of consensus, the authors suggest that clinical practice guidelines concerning this procedure be revisited.