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Surgical Interventions for a Child with Otitis Media with Indications for Surgery

Description

Once a decision has been made to proceed with surgery to manage a child with otitis media, the next step is to determine the appropriate procedure. Rovers et al proposed surgical approaches based on the child's clinical status. The authors are from the University Medical Centre in Utrecht, University Medical Centre in Nijmegen and SUNY Downstate Medical Center.


 

Parameters:

(1) initial vs repeat surgery

(2) presence or absence of nasal obstruction

(3) tonsillar symptoms (recurrent tonsillitis, pharyngeal obstruction)

(4) previous surgical resections

 

Recommendations for initial surgery:

(1) myringotomy with tympanostomy tube placement

(2) adenoidectomy only if nasal obstruction present

 

Recommendations for repeat surgery:

(1) myringotomy with tympanostomy tube placement

(2) adenoidectomy regardless of adenoidal size or symptoms (removal of any residual adenoidal tissue if previously removed)

(3) tonsillectomy only if significant tonsillar symptoms present

 


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