Abstract
We inserted the ventilation tube into seven children for recurrent acute otitis media (rAOM), who could not recover from rAOM in spite of comprehensive treatments including myringotomies, oral or intravenous administration of antibiotics, and administration of immunoglobulin.
In order to select patients for the ventilation tube insertion, we followed the indications for surgery as below.
1) Recurring otitis media purulenta more than once a month
2) Inability to recover from rAOM in spite of comprehensive treatments including myringotomies and peroral or intravenous administration of adequate antibiotics
3) Ability to undergo general anesthesia.
The average observation times before and after surgery were 8.05 and 5.10 months. During these periods, the frequency of otitis media purulenta significantly decreased (t test, p<0.0001), from 1.72/30 days to 0.14/30 days on average. It was also proved statistically that the number of days of antibiotic administration and the frequency of fever showed a significant decrease after the operation as compared with before (p=0.0007, p=0.0188).
Ventilation tube insertion is thought to be one of the effective treatments for rAOM, and avoiding the overuse of antibiotics would prevent the increase of drug-fast bacteria such as penicillin resistant Streptococcas pneumoniae and ampicillin resistant Haemophilus influenzae both in number and in the level of resistance.
