Postsurgical follow-up of children with tympanostomy tubes: Results of theAmerican Academy of Otolaryngology-Head and Neck Surgery Pediatric Otolaryngology Committee National Survey

Postsurgical follow-up of children with tympanostomy tubes is becoming a co ntentious issue in this era of managed care. Primary care providers believe themselves to be capable of evaluating these children. Otolaryngologists, on the other hand, have more specialized equipment available to them (sucti on apparatus, otomicroscopes, audiology devices, etc) for treating suppurat ive infections and monitoring the tympanic membrane for structural changes. In addition, the otalaryngologist is placed in an uncomfortable legal and ethical position if access to the patient with a tube-related complication is denied by the primary care provider. Attempts to develop an American Aca demy of Otolaryngology-Head and Neck Surgery (AAO-HNS) policy statement hav e been hampered by a lack of data on the incidence and severity of tube-rel ated complications and the role that otolaryngologists can play in reducing these sequelae. A survey designed by the AAO-HNS Pediatric Otolaryngology Committee was distributed to 1000 board-certified otolaryngologists and all members of the American Society of Pediatric Otolaryngologists and the Ame rican Academy of Pediatrics-Otolaryngology Section regarding current practi ce patterns and practitioners' experiences with tympanostomy tube complicat ions. Specific information regarding complications that could have been avo ided with earlier otolaryngology referral was also obtained. The results of the survey and its implications for AAO-HNS policy are presented.