Survey of pediatric otolaryngologists: clinical practice trends used to prevent and treat blocked ventilation ear tubes in children.

OBJECTIVE To estimate clinical impact of blocked tubes in children and to identify prevention/treatment trends. METHODS A survey was sent to American Society of Pediatric Otolaryngology (ASPO) members via Internet. RESULTS One hundred twenty two members of ASPO members responded (58%). Most clinicians saw their patients 4-8 weeks after surgery. The estimated blockage rate was between 0 and 9% (despite the use of prophylactic drops applied perioperatively including those with antibiotics only (55%), antibiotic with steroids (36%) or decongestant drops (14%), respectively). Most clinicians opted to treat blocked tube with a course of drops applied at home (73% used drops over half the time). Those drops most commonly used included the following either alone or in combination for up to 14 days: antibiotics with steroids, antibiotics alone, or either 1.5 or 3% hydrogen peroxide. Fewer clinicians used suction and/or debridement under microscopic guidance to unblock the tube at the office visit. However, most clinicians agreed that microscopic debridement was more effective than a course of drops in opening blocked tubes (80% versus 70% estimated median success rate, respectively, p=0.0003). CONCLUSIONS Approximately one half million sets of tubes (1,000,000 total tubes) are placed per year in North America. Based on results of this survey and those from the literature, 50,000 patients require treatment postoperatively because their tubes blocked (despite the use of prophylactic eardrops). This study identifies that a variety of treatments exist and confirms that further study is warranted to prevent postoperative tube blockage.