Information on Ear, Nose and Throat Surgeries
Ear Tubes, M & T, Myringotomy Tubes
Inductions for Ear Tubes
(Myringotomy Tubes)
  
        
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Middle Ear Fluid Found During Ear Tube Insertion

Clinical Indications for Myringotomy (Ear) Tubes

American Academy of Otolaryngology-Head and Neck Surgery, Bulletin June 2000 Vol. 19 No. 6, and the position statement from the American Academy of Pediatrics Subcommittee on Otitis Media with Effusion; American Academy of Family Physicians; American Academy of Otolaryngology--Head and Neck Surgery   View Abstract  
Click on colored text for word definitions !!

        

   
1.  Severe
acute otitis media (middle ear infection)
2.  Hearing loss greater than 30 dB in patients with
otitis media with effusion present for greater than  three months.

On May of 2004, the American Academy of Pediatrics Subcommittee on Otitis Media with Effusion; American Academy of Family Physicians; American Academy of Otolaryngology--Head and Neck Surgery printed guidelines for the treatment of otitis media with effusion.  They recommended the following  in children age 12 years and under:    View Abstract

1) Ear tube surgery is indicated for otitis media with effusion that is present for three months that is associated with a hearing loss. 
2) More promptly evaluate and intervene in children with speech, language or learning problems.
3) Intervene if structural abnormalities of the eardrum or middle ear develop.
4) Hearing tests should be performed on children with
otitis media with effusion present for 3 months or longer.

--Initial management consists of ear tube placement, adenoidectomy should not be performed initially unless another indication for adenoidectomy exists.
--Repeat surgery consists of adenoidectomy with myringotomy (with or with out tube insertion.)

3.  Poor response to antibiotics for otitis media.
4.  Impending
mastoiditis or intracranial complications due to otitis media.
5.  Recurrent episodes of
acute otitis media (more than 3 episodes in 6 months or more than 4 episodes in 12 months).
6.  Chronic retraction of
tympanic membrane or pars flaccida .  This may form a retraction pocket of the eardrum which may eventually form a cholesteatoma.  
7. 
Barotrauma .
8. 
Autophony (hear body sounds such as breathing) due to patulous (wide open) eustachian tube.
9. 
Craniofacial anomalies that predispose to middle ear dysfunction (e.g. cleft Palate ).
10.  Middle ear dysfunction due to head and neck radiation and skull base surgery.  {Note some feel that radiation therapy is a relative contraindication, because of a possible higher incidence of chronic infection which can lead to osteoradionecrosis (death of bony tissue due to radiation) . }

Relative Contraindication

1.  Radiation therapy to the ear, brain or nasopharynx

At least Three articles have been published which mention (in the abstract) an increased incidence of persistent otorhea in patients with nasopharyngeal carcinoma that had been treated with radiation therapy.  One abstract reported a 28% incidence of discharging otorhea at the time of the last visit.  View Abstract

The following abstracts question if ear tubes should be inserted in patients who have had radiation to the temporal bone View Abstract    View Abstract  

This abstract just mentions the problem of chronic otorhea after ear tube placement following radiation therapy to the head. 
View Abstract

Go Back To Ear Tube Placement Information Page

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