{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:27:12Z","timestamp":1786969632542,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the feasibility, effectiveness, and safety of in\u2010office tympanostomy tube placement (TTP) performed in awake pediatric patients without general anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Web of Science, and the Cochrane Library from inception through March 20, 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>We screened the abstracts of potentially eligible studies and subsequently assessed the full\u2010text reports of those deemed relevant in detail. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta\u2010analyses (PRISMA) guidelines. Study quality and risk of bias were assessed using the ROBINS\u2010I tool for non\u2010randomized studies and the AXIS tool for the single cross\u2010sectional study. Meta\u2010analyses of proportions were conducted in R using the meta package.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven studies met inclusion criteria. Office\u2010based TTP demonstrated a high pooled procedural success rate of 97% (95% CI, 0.89\u20100.99;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.01;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 86.4%). Pain levels were low, with a mean Face, Legs, Activity, Cry, and Consolability (FLACC) score of 1.26 (95% CI, 1.10\u20101.45;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%), consistent with mild discomfort. Parental satisfaction was uniformly high at 95% (95% CI, 0.92\u20100.97;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). Adverse events were infrequent, generally mild, and comparable in severity to those reported for operating\u2010room tympanostomy under general anesthesia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Office\u2010based TTP in awake pediatric patients appears to be a safe, effective, and well\u2010tolerated alternative to operative tympanostomy under general anesthesia, offering high success rates, minimal discomfort, and strong caregiver acceptance while reducing anesthesia exposure and healthcare costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70389","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:55:26Z","timestamp":1786967726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["In\u2010Office Tympanostomy Tube Placement in Awake Pediatric Patients: A Meta\u2010analysis of Proportions"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8161-6430","authenticated-orcid":false,"given":"Lucas Macedo","family":"Nascimento","sequence":"first","affiliation":[{"name":"Faculty of Medicine Universidade de Bras\u00edlia Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0709-8404","authenticated-orcid":false,"given":"Caio Toscano","family":"Lessa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Universidade de Bras\u00edlia Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0755-7125","authenticated-orcid":false,"given":"Ana Clara Monte","family":"Varandas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Catholic University of Brasilia Bras\u00edlia DF Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8667-7131","authenticated-orcid":false,"given":"Jo\u00e3o Victor Pereira","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Medicine Bahiana School of Health and Public Health Salvador BA Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9421-9753","authenticated-orcid":false,"given":"Valentina Meinhardt","family":"Ronchetti","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Federal University of Rio Grande do Sul Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-1303","authenticated-orcid":false,"given":"Andr\u00e9 Luiz Lopes","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Universidade de Bras\u00edlia Bras\u00edlia DF 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