title: A systematic review of the effect of tympanostomy tubes in children with recurrent acute otitis media.
abstract: OBJECTIVE
  Documentation of the effect of tympanostomy tubes in children with recurrent acute otitis media (RAOM) is limited. A recently published Cochrane review on the effect of tympanostomy tubes in children with RAOM was based on only two studies. Could the documentation be increased by including other randomized studies?
  
  
  METHODS
  A MEDLINE and EMBASE search for randomized controlled trials was performed and 143 eligible papers were found. Only five studies could be included. All five were randomized studies with a total of 519 children, four randomized by children and one by ears. All five studies had different designs and control groups, making a proper meta-analysis impossible. Three studies had an antibiotic treated group, two studies a placebo group, and two studies a no treatment group as comparison group. Outcome measures were rates of AOM or fraction free of AOM in six or 12 months.
  
  
  RESULTS
  Between two and five children have to be treated with tympanostomy tubes to prevent one child from attacks of acute otitis media (AOM) in six months. Tube treatment could reduce AOM with about one attack in six months after operation. Six months treatment with antibiotics was not different from treatment with tubes. No study reported quality of life for child and family or parental absence from day care or work.
  
  
  CONCLUSIONS
  Insertion of tympanostomy tubes or long-term treatment with antibiotics seems to prevent one attack of AOM or keep one child out of three free from AOM in six months.
authors.affiliation: Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Denmark. jlous@health.sdu.dk
authors.forename: Jørgen
authors.initials: J
authors.lastname: Lous
authors.forename: Christina T
authors.initials: CT
authors.lastname: Ryborg
authors.forename: Janus L
authors.initials: JL
authors.lastname: Thomsen
mesh_terms: D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D003718:Denmark; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects / Q000379:methods*; D010033:Otitis Media / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D018570:Risk Assessment; D016896:Treatment Outcome