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• W1958252340 abstract "Background Acute otitis media (AOM) is one of the most common childhood illnesses. While many children experience sporadic AOM episodes, an important group suffer from recurrent AOM (rAOM), defined as three or more episodes in six months, or four or more in one year. In this subset of children AOM poses a true burden through frequent episodes of ear pain, general illness, sleepless nights and time lost from nursery or school. Grommets, also called ventilation or tympanostomy tubes, can be offered for rAOM. Objectives To assess the benefits and harms of bilateral grommet insertion with or without concurrent adenoidectomy in children with rAOM. Search methods The Cochrane ENT Information Specialist searched the Cochrane ENT Trials Register; CENTRAL; MEDLINE; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 4 December 2017. Selection criteria Randomised controlled trials (RCTs) comparing bilateral grommet insertion with or without concurrent adenoidectomy and no ear surgery in children up to age 16 years with rAOM. We planned to apply two main scenarios: grommets as a single surgical intervention and grommets as concurrent treatment with adenoidectomy (i.e. children in both the intervention and comparator groups underwent adenoidectomy). The comparators included active monitoring, antibiotic prophylaxis and placebo medication. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Primary outcomes were: proportion of children who have no AOM recurrences at three to six months follow‐up (intermediate‐term) and persistent tympanic membrane perforation (significant adverse event). Secondary outcomes were: proportion of children who have no AOM recurrences at six to 12 months follow‐up (long‐term); total number of AOM recurrences, disease‐specific and generic health‐related quality of life, presence of middle ear effusion and other adverse events at short‐term, intermediate‐term and long‐term follow‐up. We used GRADE to assess the quality of the evidence for each outcome; this is indicated in italics. Main results Five RCTs (805 children) with unclear or high risk of bias were included. All studies were conducted prior to the introduction of pneumococcal vaccination in the countries' national immunisation programmes. In none of the trials was adenoidectomy performed concurrently in both groups. Grommets versus active monitoring Grommets were more effective than active monitoring in terms of: ‐ proportion of children who had no AOM recurrence at six months (one study, 95 children, 46% versus 5%; risk ratio (RR) 9.49, 95% confidence interval (CI) 2.38 to 37.80, number needed to treat to benefit (NNTB) 3; low‐quality evidence); ‐ proportion of children who had no AOM recurrence at 12 months (one study, 200 children, 48% versus 34%; RR 1.41, 95% CI 1.00 to 1.99, NNTB 8; low‐quality evidence); ‐ number of AOM recurrences at six months (one study, 95 children, mean number of AOM recurrences per child: 0.67 versus 2.17, mean difference (MD) ‐1.50, 95% CI ‐1.99 to ‐1.01; low‐quality evidence); ‐ number of AOM recurrences at 12 months (one study, 200 children, one‐year AOM incidence rate: 1.15 versus 1.70, incidence rate difference ‐0.55, 95% ‐0.17 to ‐0.93; low‐quality evidence). Children receiving grommets did not have better disease‐specific health‐related quality of life (Otitis Media‐6 questionnaire) at four (one study, 85 children) or 12 months (one study, 81 children) than those managed by active monitoring (low‐quality evidence). One study reported no persistent tympanic membrane perforations among 54 children receiving grommets (low‐quality evidence). Grommets versus antibiotic prophylaxis It is uncertain whether or not grommets are more effective than antibiotic prophylaxis in terms of: ‐ proportion of children who had no AOM recurrence at six months (two studies, 96 children, 60% versus 35%; RR 1.68, 95% CI 1.07 to 2.65, I2 = 0%, fixed‐effect model, NNTB 5; very low‐quality evidence); ‐ number of AOM recurrences at six months (one study, 43 children, mean number of AOM recurrences per child: 0.86 versus 1.38, MD ‐0.52, 95% CI ‐1.37 to 0.33; very low‐quality evidence). Grommets versus placebo medication Grommets were more effective than placebo medication in terms of: ‐ proportion of children who had no AOM recurrence at six months (one study, 42 children, 55% versus 15%; RR 3.64, 95% CI 1.20 to 11.04, NNTB 3; very low‐quality evidence); ‐ number of AOM recurrences at six months (one study, 42 children, mean number of AOM recurrences per child: 0.86 versus 2.0, MD ‐1.14, 95% CI ‐2.06 to ‐0.22; very low‐quality evidence). One study reported persistent tympanic membrane perforations in 3 of 76 children (4%) receiving grommets (low‐quality evidence). Subgroup analysis There were insufficient data to determine whether presence of middle ear effusion at randomisation, type of grommet or age modified the effectiveness of grommets. Authors' conclusions Current evidence on the effectiveness of grommets in children with rAOM is limited to five RCTs with unclear or high risk of bias, which were conducted prior to the introduction of pneumococcal vaccination. Low to very low‐quality evidence suggests that children receiving grommets are less likely to have AOM recurrences compared to those managed by active monitoring and placebo medication, but the magnitude of the effect is modest with around one fewer episode at six months and a less noticeable effect by 12 months. The low to very low quality of the evidence means that these numbers need to be interpreted with caution since the true effects may be substantially different. It is uncertain whether or not grommets are more effective than antibiotic prophylaxis. The risk of persistent tympanic membrane perforation after grommet insertion was low. Widespread use of pneumococcal vaccination has changed the bacteriology and epidemiology of AOM, and how this might impact the results of prior trials is unknown. New and high‐quality RCTs of grommet insertion in children with rAOM are therefore needed. These trials should not only focus on the frequency of AOM recurrences, but also collect data on the severity of AOM episodes, antibiotic consumption and adverse effects of both surgery and antibiotics. This is particularly important since grommets may reduce the severity of AOM recurrences and allow for topical rather than oral antibiotic treatment." @default.
• W1958252340 created "2016-06-24" @default.
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• W1958252340 date "2018-05-09" @default.
• W1958252340 modified "2023-10-10" @default.
• W1958252340 title "Grommets (ventilation tubes) for recurrent acute otitis media in children" @default.
• W1958252340 cites W1482787702 @default.
• W1958252340 cites W1496852536 @default.
• W1958252340 cites W1577324142 @default.
• W1958252340 cites W1604318881 @default.
• W1958252340 cites W1845923557 @default.
• W1958252340 cites W1847505314 @default.
• W1958252340 cites W1958252340 @default.
• W1958252340 cites W1965163461 @default.
• W1958252340 cites W1974348566 @default.
• W1958252340 cites W1976693872 @default.
• W1958252340 cites W1982245642 @default.
• W1958252340 cites W1982912848 @default.
• W1958252340 cites W1984079328 @default.
• W1958252340 cites W1988845581 @default.
• W1958252340 cites W1989423376 @default.
• W1958252340 cites W1994578277 @default.
• W1958252340 cites W1995100859 @default.
• W1958252340 cites W1996774484 @default.
• W1958252340 cites W1996965530 @default.
• W1958252340 cites W2005941222 @default.
• W1958252340 cites W2010676240 @default.
• W1958252340 cites W2013168997 @default.
• W1958252340 cites W2034153524 @default.
• W1958252340 cites W2035431567 @default.
• W1958252340 cites W2036849734 @default.
• W1958252340 cites W2040737980 @default.
• W1958252340 cites W2044323817 @default.
• W1958252340 cites W2051707698 @default.
• W1958252340 cites W2055627662 @default.
• W1958252340 cites W2057456741 @default.
• W1958252340 cites W2059869921 @default.
• W1958252340 cites W2065673455 @default.
• W1958252340 cites W2070398317 @default.
• W1958252340 cites W2073532367 @default.
• W1958252340 cites W2074767095 @default.
• W1958252340 cites W2081819577 @default.
• W1958252340 cites W2088623763 @default.
• W1958252340 cites W2089467774 @default.
• W1958252340 cites W2093526991 @default.
• W1958252340 cites W2107415250 @default.
• W1958252340 cites W2118710869 @default.
• W1958252340 cites W2119802472 @default.
• W1958252340 cites W2122040197 @default.
• W1958252340 cites W2125435699 @default.
• W1958252340 cites W2132092018 @default.
• W1958252340 cites W2143103195 @default.
• W1958252340 cites W2150500774 @default.
• W1958252340 cites W2159189010 @default.
• W1958252340 cites W2161213320 @default.
• W1958252340 cites W2166842984 @default.
• W1958252340 cites W2328198785 @default.
• W1958252340 cites W2416115877 @default.
• W1958252340 cites W2417020255 @default.
• W1958252340 cites W2431660213 @default.
• W1958252340 cites W2605667004 @default.
• W1958252340 cites W2616720689 @default.
• W1958252340 cites W2617919131 @default.
• W1958252340 cites W4211248544 @default.
• W1958252340 cites W4237734340 @default.
• W1958252340 cites W4240268084 @default.
• W1958252340 cites W4245389488 @default.
• W1958252340 cites W4251327444 @default.
• W1958252340 cites W4251387366 @default.
• W1958252340 cites W4252438194 @default.
• W1958252340 doi "https://doi.org/10.1002/14651858.cd012017.pub2" @default.
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