title: To tube or not to tube:  indications for myringotomy with tube placement.
abstract: OBJECTIVE
  To examine the current indications for myringotomy with tube placement.
  
  
  RESULTS
  In 2004, revised clinical practice guidelines for otitis media with effusion (OME) and acute otitis media (AOM) were published. Because of the rate of spontaneous resolution of otitis in children, these guidelines suggest more 'watchful waiting' in both disease processes. Recent literature has recommended an even longer observation period in children with OME of up to 9-18 months. In adults, indications for myringotomy with tube placement have remained unchanged. We will discuss the changes in indications for myringotomy with tube placement and review the recent literature and trends in this area.
  
  
  CONCLUSIONS
  In children, indicator guideline changes have been shown to not affect speech, language, and cognitive development, but further study is needed to find the right balance of observation, antibiotics, and myringotomy with tube placement for otitis media. Future vaccines may further decrease the number of children requiring myringotomy with tube placement for otitis media.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Smith
authors.forename: John
authors.initials: J
authors.lastname: Greinwald
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008876:Middle Ear Ventilation / Q000379:methods*; D009225:Myringoplasty / Q000379:methods*; D010034:Otitis Media with Effusion / Q000209:etiology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D057832:Watchful Waiting