Research Activities #248, April 2001

the Agency for Healthcare Research and Quality and the National Institute of Child Health and Human Development indicates that in most cases, inserting tubes in the eardrums—a procedure called tympanostomy— of children under age 3 who have fluid in the middle ear has no measurable effect on improving their speech, language, cognitive, or psychosocial development at age 3. Fluid in the middle ear—otitis media with effusion (OME)—is usually associated with a mild to moderate hearing loss that, although temporary, has been thought by some health professionals to result in longterm impairment of children’s development. Approximately 280,000 children under age 3 undergo tympanostomy each year, according to 1996 estimates. Jack L. Paradise, M.D., and his colleagues at the Children’s Hospital of Pittsburgh and the University of Pittsburgh enrolled 6,350 healthy infants from 2 to 61 days of age in the study and evaluated them regularly for middle-ear effusion. Before the age of 3 years, 429 children with persistent effusion were randomly assigned to have tympanostomy tubes inserted either as soon as possible or up to 9 months later if effusion persisted. By age 3, 169 children in the early-treatment group (82 percent) and 66 children in the late-treatment group had received tympanostomy tubes. There were no significant differences between the two groups of children in speech, language, cognition, or psychosocial development. Most of the children in the early-surgery group received surgery within 60 days, whereas most in the latesurgery group either received surgery after more than 6 months or had not received surgery by age 3. The study was conducted between May 1991 and December 1995. On the General Cognitive Index of the McCarthy Scales of Children’s Abilities, the children in the early-surgery group tested at 99, and the children in the latesurgery group tested at 101; both Research Activities