EBP Compendium: Summary of Systematic Review

The Cochrane Collaboration; the Institute and Research Unit of General Practic, Arhus University; Arhus University Research Foundation; Institute of Public Health, University of Southern Denmark; the Foundation for Research in General Practice and the Health Care System (Denmark)
Grommets (Ventilation Tubes) for Hearing Loss Associated with Otitis Media with Effusion in Children
Browning, G. G., Rovers, M. M., et al. (2010).
Cochrane Database of Systematic Reviews(10).

Indicators of Review Quality:

Description: This is a review of randomized controlled trials investigating the effect of grommets (ventilation tubes) for children with otitis media with effusion (OME).

Question(s) Addressed:

Question not specifically stated.

Population: Children aged one to twelve years with unilateral or bilateral otitis media with effusion.

Intervention/Assessment: Tube insertion, myringotomy, non-surgical treatment (including watchful waiting and antibiotics)

Number of Studies Included: 17

Years Included: 1966 - March 2003

Findings:

Conclusions:

• Management
  • Speech and Language
    • Grommets/Ventilation Tubes
      • "In otherwise healthy children with long-standing OME and hearing loss, early insertion of grommets had no effect on language development or cognition" (p. 2).
      • "Watchful waiting would appear to be an appropriate management strategy for most children with glue ear" (p. 2).
      • "As no evidence is yet available for the subgroups of children with speech or language delays, beahvioural and learning problems or children with defined clinical syndromes, the clinician will need to make decisions regarding treatment for such children based on other evidence and indications of disability related to hearing impairment" (p. 12).
    • Watchful Waiting
      • The review did not find any evidence that grommets help speech and language development. Watchful waiting would appear to be ana appropriate management strategy for most children with glue ear" (p. 2).
      • "As no evidence is yet available for the subgroups of children with speech or language delays, beahvioural and learning problems or children with defined clinical syndromes, the clinician will need to make decisions regarding treatment for such children based on other evidence and indications of disability related to hearing impairment" (p. 12).
  • Hearing
    • Grommets/Ventilation Tubes
      • Treatment with grommets improved the mean hearing level by approximately 9 dB after the first 6 months and 6 dB after one year. "The benefits of grommets in children with simple glue ear (otitis media with effusion or OME) and no other serious medical problems appear small" (p. 12).
      • "The effects of grommets on hearing diminished during the first year. Potentially adverse effects on the tympanic membrane are common after grommet insertion. Therefore an initial period of watchful waiting seems to be an appropriate management strategy from most children with OME" (p. 2).
    • Watchful Waiting
      • Because grommets offer only short-term hearing improvement in children with OME, "watchful waiting would appear to be an appropriate management strategy" for most children with OME (p. 2).

Keywords: Otitis Media

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Added to Compendium: January 2012