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Surgical prevention of otitis media.
Rosenfeld, R M.
Afiliación
  • Rosenfeld RM; Department of Otolaryngology, SUNY Health Science Center at Brooklyn, 339 Hicks Street, Brooklyn, NY 11201, USA. richrosenfeld@msn.com
Vaccine ; 19 Suppl 1: S134-9, 2000 Dec 08.
Article en En | MEDLINE | ID: mdl-11163477
Increasing concerns over drug-resistant bacteria mandate that alternative methods of treatment and prevention, including surgery, be considered to reduce antibiotic usage for acute otitis media (AOM). Meta-analysis of five randomized trials of tubes versus no surgery showed a mean absolute decrease in AOM incidence of 1.0 episode per child-year (95% CI, 0.4-1.6), with a relative decrease of 56%. Similarly, the prevalence of middle-ear effusion decreased by 115 days per child-year (95% CI, 11-220). Within several weeks of tube placement 79% of children had improved quality of life, 17% had trivial change, and 4% were worse. Systematic review of 134 articles revealed transient post-operative otorrhea in 16% of patients with tubes, and later in 26%; recurrent otorrhea occurred in 7.4% of patients and chronic otorrhea in 3.8% Adenoidectomy reduced AOM incidence by 0.32 episodes per child-year (95% CI, 0.03-0.61) for a 3-year period in one study (26% relative decrease), but the effect was only significant for children with prior tubes. Surgical therapy of otitis media offers significant benefits and is an effective prevention strategy in selected children.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Otitis Media / Ventilación del Oído Medio / Adenoidectomía Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Aspecto: Patient_preference Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: Vaccine Año: 2000 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Otitis Media / Ventilación del Oído Medio / Adenoidectomía Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Aspecto: Patient_preference Límite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: Vaccine Año: 2000 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos