Update to Clinical Practice Guideline on Tympanostomy Tube Surgery for Children

On February 9, the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) published the Clinical Practice Guideline: Tympanostomy Tubes in Children (Update) in Otolaryngology-Head and Neck Surgery. Tympanostomy tubes, also called ear tubes, effectively lower or eliminate middle ear infections and eliminate persistent middle ear fluid and hearing loss related to middle ear fluid.

” As the most prevalent ambulatory surgery conducted on children in the United States, insertion of tympanostomy tubes should be informed by trustworthy recommendations based upon the best and most current research available, which is precisely what the new, completely updated CPG from AAO-HNSF achieves,” claimed Richard M. Rosenfeld, MD, MPH, MBA, Chair of the Guideline Update Group (GUG).

This CPG update aims to reassess and update recommendations in the previous guideline and supply clinicians with evidence-based recommendations on patient selection and surgical indications for managing tympanostomy tubes in children. 

Original guideline Vs update

Revisions and addendums in this update compared to the original 2013 CPG consist of substantial patient education materials, possibilities for shared decision-making, expanded action statement profiles that currently include:

• quality improvement and implementation considerations;
•  a flowchart that loops all action statements in a logical management plan; 
• a simple language version, especially for consumers and patients; 
• a specialized webpage with downloadable patient education materials.

” Perhaps what is most amazing about the updated CPG is just how it is part of a extensive suite of supporting materials,” said Dr. Rosenfeld. “The bottom line is that tympanostomy tubes– placed in the right child, for the appropriate reason, and managed properly– can offer children and families amazing benefits, which are best attained by complying with the outstanding multidisciplinary guidance in this brand-new update.”

The original guideline, released in 2013 and currently with more than 500 citations, offered the first trustworthy recommendations on tympanostomy tube indications. 

Following research revealed exceptional adherence by clinicians to guideline recommendations for tube insertion and watchful waiting to lower unnecessary surgery. 

The AAO-HNSF guideline remains the only publication explicitly focused on tympanostomy tube indications and handling children that get tubes.

The guideline is aimed at any kind of clinician involved in handling children aged six months to 12 years with tympanostomy tubes or children being pondered for tympanostomy tubes in any care setting as an intervention for middle ear swelling. 

The target audience for this CPG update consists of specialists, primary care clinicians, and allied health professionals, as represented by the multidisciplinary GUG. This included the disciplines of :

• otolaryngology/head and neck surgery;
• otology;
• pediatrics; 
• audiology; 
• anesthesiology; 
• family medicine; 
• advanced practice nursing; 
• speech-language pathology;
• consumer advocacy.

Read the original article on News Medical.

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