Rates of visits for otitis media are going down while tube placements are going up, leading investigators at the Pediatric Academic Societies 2009 Annual Meeting in Baltimore to fear that surgeons are overtreating some cases and also missing cases of recurrent otitis media.
"There is absolutely no evidence of long-term benefit with tube placement for otitis media," says Robert M. Jacobson, MD, chair of the Department of Pediatrics at the Mayo Clinic in Rochester, Minn. "We need to avoid treatment of ear infections with tympanostomy tubes."
The insertion of tympanostomy tubes for recurrent ear infections has increased 35% in the past decade, and the number of visits for otitis media has decreased by about one-fourth, according to a comparison of 1996 and 2006 data from the National Center for Health Statistics, through the National Survey of Ambulatory Surgery, on the use of tympanostomy tubes in children 16 years of age and younger. The data show that in 1996, there were 493,219 ear-tube insertions performed. In 2006, there were 668,245 tube insertions.
Tympanostomy tube placement increased 28% per capita between 1996 and 2006, to 0.96 surgeries per 100 children. However, at the same time, there were 27% fewer visits for otitis media in 2006 than in 1996. Surgeries increased from 2.1 procedures per 100 hospital outpatient visits for otitis media in 1996 to 3.8 procedures per 100 visits in 2006.
—Dan O’Connor
SOURCE: Pediatric Academic Societies (PAS) 2009 Annual Meeting: Abstract 4525.7. Presented May 4, 2009.
