title: Surgical management of otitis media.
abstract: In summary there are four surgical procedures commonly used for treatment of otitis media. Myringotomy and aspiration of the middle ear effusion is indicated for acute otitis media: (1) when a child has persistent or recurrent symptoms while on appropriate antimicrobial therapy; (2) if there is severe otalgia initially requiring immediate relief; (3) when a suppurative complication is present, such as facial paralysis; or (4) whenever a diagnostic tympanocentesis (for microbiology) is indicated, such as for the critically ill child, the neonate or a child who is immunologically compromised. In addition the potential benefit from more liberal use of the procedure initially might decrease the persistence and recurrence. Myringotomy without tympanostomy tube insertion is a reasonable treatment option for infants and children with chronic otitis media with effusion that is unresponsive to antimicrobial therapy if the procedure can be performed without the administration of a general anesthetic; however, if not, then a tympanostomy tube should be inserted since the recurrence rate is high. In addition to chronic otitis media with effusion, myringotomy with tympanostomy tube insertion is indicated for: (1) recurrent acute otitis media, especially if unresponsive to prophylactic antimicrobial therapy; (2) eustachian tube dysfunction, in which one or more of the following is present--otalgia, significant and symptomatic hearing loss, vertigo or tinnitus; (3) severe retraction pocket of the tympanic membrane; (4) suppurative complication to maintain adequate drainage; and (5) at the time of repair of a tympanic membrane defect, i.e. tympanoplasty, when the eustachian tube function is poor.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000208:Acute Disease; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003131:Combined Modality Therapy; D006801:Humans; D007223:Infant; D010033:Otitis Media / Q000188:drug therapy / Q000601:surgery*; D010034:Otitis Media with Effusion / Q000601:surgery; D010035:Otitis Media, Suppurative / Q000601:surgery; D014433:Tympanoplasty
chemical_list: D000890:Anti-Infective Agents