Developmental Outcomes after Early or Delayed Insertion of Tympanostomy Tubes

In children younger than three years of age with persistent middle-ear effusion, prompt insertion of tympanostomy tubes, as compared with delayed insertion up to nine months later if effusion persisted, did not improve developmental outcomes in the children when they were six years old. These data support current recommendations not to routinely insert tubes in otherwise healthy children solely on the basis of a persistent middle-ear effusion. In children younger than three years of age with persistent middle-ear effusion, prompt insertion of tympanostomy tubes, as compared with delayed insertion up to nine months later, did not improve developmental outcomes in the children when they were six years old. Among children in the United States, otitis media is the most commonly diagnosed illness after the common cold, 1 and myringotomy with the insertion of tympanostomy tubes is the most common operation beyond the newborn period. 2 An estimated 280,000 children younger than three years of age underwent the operation in 1996 (Kozak LJ: personal communication). Often the operation has been undertaken in young children to relieve persistent middle-ear effusion, out of concern that the commonly associated conductive hearing loss might have lasting adverse effects on the cognitive, speech, language, or psychosocial development of the children. 3 – 5 Supporting that practice have been . . .