Tympanostomy tubes in the otitis media prone child.
Otitis media has long been recognized as one of the most common diseases of childhood. A prospective randomized study was designed with patients who had multiple episodes of acute purulent otitis media. Comparison of infection rates was made between patients treated with conventional antibiotic therapy for each episode and patients who had tympanostomy tubes placed. Placement of tympanostomy tubes significantly decreased the number of episodes of acute purulent otitis media and was shown to be an effective method of prophylaxis in the "otitis prone" child. Immunoglobulin levels in the middle ear in this group of patients were found to be similar to those levels in patients with otitis media with effusion. This supports the hypothesis that a dynamic relationship between the different clinical entities of otitis media exists.
Grommets have a significant role in maintaining a 'disease-free' state in the first six months after insertion. Further research is required to investigate the effect beyond six months. Clinicians should consider the possible adverse effects of grommet insertion before surgery is undertaken.