{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:50:05Z","timestamp":1792788605632,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Children with recurrent acute otitis media (RAOM) presenting without middle ear effusion (MEE) do not meet indications for surgical intervention as outlined by Clinical Practice Guidelines (CPGs). The objective of this study was to determine which patients presenting with RAOM without MEE ultimately received tympanostomy tubes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single academic pediatric otolaryngology clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children (0\u201012 years) presenting with RAOM and no MEE were identified from October 2017 to December 2019. As per CPGs, no surgery was offered initially. Patients were given a semiurgent return appointment should they experience another suspected otitis media episode. If MEE was observed, tympanostomy tube insertion was offered. Patients were followed for 1\u2010year following enrollment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One\u2010hundred and twenty\u2010four patients were included. The median age was 3.15 years old (interquartile range: 4.10). Seventy\u2010five (60%) patients did not require additional follow\u2010up and thus did not require tympanostomy tubes. Forty\u2010nine (40%) patients were seen again; of these, 11 patients received tympanostomy tubes. Therefore, of patients presenting with no MEE, 91% did not require tympanostomy tubes. Patients who had surgery were younger on initial assessment than those who did not (mean difference 2.68 years, 95% confidence interval: 2.14\u20103.23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates the practical effect of adhering to CPGs for RAOM and suggests that many children may not require tympanostomy tube placement within the 1st year after the consultation if they did not initially present with MEE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.299","type":"journal-article","created":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T21:36:02Z","timestamp":1675632962000},"page":"685-691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Need for Tympanostomy Tubes in Children With Recurrent Acute Otitis Media Without Middle Ear Effusion"],"prefix":"10.1002","volume":"169","author":[{"given":"Alexander","family":"Clark","sequence":"first","affiliation":[{"name":"Division Otolaryngology\u2010Head and Neck Surgery Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Forner","sequence":"additional","affiliation":[{"name":"Division Otolaryngology\u2010Head and Neck Surgery Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Noel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Corsten","sequence":"additional","affiliation":[{"name":"Division Otolaryngology\u2010Head and Neck Surgery Dalhousie University  Halifax Nova Scotia Canada"},{"name":"IWK Health Centre  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Hong","sequence":"additional","affiliation":[{"name":"Division Otolaryngology\u2010Head and Neck Surgery Dalhousie University  Halifax Nova Scotia Canada"},{"name":"IWK Health Centre  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","article-title":"Grommets (ventilation tubes) for recurrent acute otitis media in children","volume":"2018","author":"Venekamp RP","year":"2018","journal-title":"Cochrane Database Syst 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