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Surgical Treatments for Otitis Media With Effusion: A Systematic Review.

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Title: Surgical Treatments for Otitis Media With Effusion: A Systematic Review.
Authors: Wallace, Ina F., Berkman, Nancy D., Lohr, Kathleen N., Harrison, Melody F., Kimple, Adam J., Steiner, Michael J.
Source: Pediatrics. Feb2014, Vol. 133 Issue 2, p296-311. 16p. 1 Diagram, 5 Charts.
Subjects: Adenoidectomy, CINAHL database, Information storage & retrieval systems, Medical databases, MEDLINE, Meta-analysis, Otitis media with effusion, Health outcome assessment, Quality of life, Systematic reviews, Middle ear ventilation, Treatment effectiveness
Abstract: BACKGROUND AND OBJECTIVE: The near universality of otitis media with effusion (OME) in children makes a comparative review of treatment modalities important. This study's objective was to compare the effectiveness of surgical strategies currently used for managing OME. METHODS: We identified 3 recent systematic reviews and searched 4 major electronic databases. Eligible studies included randomized controlled trials, nonrandomized trials, and cohort studies that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting. Using established criteria, pairs of reviewers independently selected, extracted data, rated risk of bias, and graded strength of evidence of relevant studies. We incorporated meta-analyses from the earlier reviews and synthesized additional evidence qualitatively. RESULTS: We identified 41 unique studies through the earlier reviews and our independent searches. In comparison with watchful waiting or myringotomy (or both), tubes decreased time with OME and improved hearing; no specific tube type was superior. Adenoidectomy alone, as an adjunct to myringotomy, or combined with tubes, reduced OME and improved hearing in comparison with either myringotomy or watchful waiting. Tubes and watchful waiting did not differ in language, cognitive, or academic outcomes. Otorrhea and tympanosclerosis were more common in ears with tubes. Adenoidectomy increased the risk of postsurgical hemorrhage. CONCLUSIONS: Tubes and adenoidectomy reduce time with OME and improve hearing in the short-term. Both treatments have associated harms. Large, well-controlled studies could help resolve the risk- benefit ratio by measuring acute otitis media recurrence, functional outcomes, quality of life, and long-term outcomes. Research is needed to support treatment decisions in subpopulations, particularly in patients with comorbidities. [ABSTRACT FROM AUTHOR]
Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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DbLabel: Psychology and Behavioral Sciences Collection
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PubType: Academic Journal
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  Data: Surgical Treatments for Otitis Media With Effusion: A Systematic Review.
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  Data: <searchLink fieldCode="AR" term="%22Wallace%2C+Ina+F%2E%22">Wallace, Ina F.</searchLink><br /><searchLink fieldCode="AR" term="%22Berkman%2C+Nancy+D%2E%22">Berkman, Nancy D.</searchLink><br /><searchLink fieldCode="AR" term="%22Lohr%2C+Kathleen+N%2E%22">Lohr, Kathleen N.</searchLink><br /><searchLink fieldCode="AR" term="%22Harrison%2C+Melody+F%2E%22">Harrison, Melody F.</searchLink><br /><searchLink fieldCode="AR" term="%22Kimple%2C+Adam+J%2E%22">Kimple, Adam J.</searchLink><br /><searchLink fieldCode="AR" term="%22Steiner%2C+Michael+J%2E%22">Steiner, Michael J.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Feb2014, Vol. 133 Issue 2, p296-311. 16p. 1 Diagram, 5 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Adenoidectomy%22">Adenoidectomy</searchLink><br /><searchLink fieldCode="DE" term="%22CINAHL+database%22">CINAHL database</searchLink><br /><searchLink fieldCode="DE" term="%22Information+storage+%26+retrieval+systems%22">Information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+databases%22">Medical databases</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Otitis+media+with+effusion%22">Otitis media with effusion</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+ear+ventilation%22">Middle ear ventilation</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND AND OBJECTIVE: The near universality of otitis media with effusion (OME) in children makes a comparative review of treatment modalities important. This study's objective was to compare the effectiveness of surgical strategies currently used for managing OME. METHODS: We identified 3 recent systematic reviews and searched 4 major electronic databases. Eligible studies included randomized controlled trials, nonrandomized trials, and cohort studies that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting. Using established criteria, pairs of reviewers independently selected, extracted data, rated risk of bias, and graded strength of evidence of relevant studies. We incorporated meta-analyses from the earlier reviews and synthesized additional evidence qualitatively. RESULTS: We identified 41 unique studies through the earlier reviews and our independent searches. In comparison with watchful waiting or myringotomy (or both), tubes decreased time with OME and improved hearing; no specific tube type was superior. Adenoidectomy alone, as an adjunct to myringotomy, or combined with tubes, reduced OME and improved hearing in comparison with either myringotomy or watchful waiting. Tubes and watchful waiting did not differ in language, cognitive, or academic outcomes. Otorrhea and tympanosclerosis were more common in ears with tubes. Adenoidectomy increased the risk of postsurgical hemorrhage. CONCLUSIONS: Tubes and adenoidectomy reduce time with OME and improve hearing in the short-term. Both treatments have associated harms. Large, well-controlled studies could help resolve the risk- benefit ratio by measuring acute otitis media recurrence, functional outcomes, quality of life, and long-term outcomes. Research is needed to support treatment decisions in subpopulations, particularly in patients with comorbidities. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=94358787
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1542/peds.2013-3228
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 16
        StartPage: 296
    Subjects:
      – SubjectFull: Adenoidectomy
        Type: general
      – SubjectFull: CINAHL database
        Type: general
      – SubjectFull: Information storage & retrieval systems
        Type: general
      – SubjectFull: Medical databases
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      – SubjectFull: MEDLINE
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      – SubjectFull: Meta-analysis
        Type: general
      – SubjectFull: Otitis media with effusion
        Type: general
      – SubjectFull: Health outcome assessment
        Type: general
      – SubjectFull: Quality of life
        Type: general
      – SubjectFull: Systematic reviews
        Type: general
      – SubjectFull: Middle ear ventilation
        Type: general
      – SubjectFull: Treatment effectiveness
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    Titles:
      – TitleFull: Surgical Treatments for Otitis Media With Effusion: A Systematic Review.
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            NameFull: Lohr, Kathleen N.
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            NameFull: Harrison, Melody F.
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            NameFull: Kimple, Adam J.
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              Text: Feb2014
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              Y: 2014
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