Cochrane · systematic review · CD015215
Ventilation tubes (grommets) for otitis media with effusion (OME) in children
MacKeith, S, Mulvaney, CA, Galbraith, K, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
ENTAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
16
current version
GRADE rated
11
No studies
5
Included studies
NR
No studies 5 · 31.3%Ungraded 0 · 0%Very low 8 · 50%Low 2 · 12.5%Moderate 1 · 6.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Ventilation tubes compared to no treatment for OME in children
Population: children aged 6 months to 12 years with OME
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hearing ‐ return to normal hearing Randomised by ear: normal defined as < 15 dB Assumed CC = 0.5 Ventilation tubes vs no treatment | OR 1.13 [0.46, 2.74] | NR | Very low Downgraded: risk of bias, inconsistency |
Disease‐specific quality of life Ventilation tubes vs no treatment | no estimate extracted | NR | No studies |
Presence/persistence of OME Randomised by child Adjusted for non‐independence of within‐individual measurements, assumed ICC = 0.5 Ventilation tubes vs no treatment | RR 0.3 [0.14, 0.65] | NR | Low Downgraded: imprecision, indirectness |
Adverse event: persistent perforation Randomised by ear, assumed CC = 0.5 Ventilation tubes vs no treatment | OR 0.85 [0.38, 1.91] | NR | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Early ventilation tubes compared to watchful waiting (treatment later if required) for OME in children
Population: children aged 6 months to 12 years with OME
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hearing ‐ return to normal hearing Randomised by child Early ventilation tubes vs watchful waiting (treatment later if required) | RR 0.98 [0.94, 1.03] | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Disease‐specific quality of life Early ventilation tubes vs watchful waiting (treatment later if required) | no estimate extracted | NR | No studies |
Presence/persistence of OME Randomised by child Early ventilation tubes vs watchful waiting (treatment later if required) | RR 1.21 [0.84, 1.74] | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse event: persistent perforation Early ventilation tubes vs watchful waiting (treatment later if required) | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Ventilation tubes compared to non‐surgical treatment for OME in children
Population: children aged 6 months to 12 years with OME
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hearing ‐ mean final hearing threshold (4 months ‐ medium‐term) № of participants: 125 (1 RCT) Ventilation tubes vs non‐surgical treatment | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision, indirectness |
Disease‐specific quality of life Ventilation tubes vs non‐surgical treatment | no estimate extracted | NR | No studies |
Presence/persistence of OME Ventilation tubes vs non‐surgical treatment | no estimate extracted | NR | No studies |
Adverse event: persistent perforation (18 months ‐ long‐term) № of participants: 60 (1 RCT) Ventilation tubes vs non‐surgical treatment | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision, indirectness |
Ventilation tubes compared to myringotomy for OME in children
Population: children aged 6 months to 12 years with OME
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hearing ‐ return to normal *Ventilation tubes versus laser myringotomy (6 to 12 months ‐ medium‐term) Adjusted for non‐independence of within‐individual measurements Assumed ICC of 0.5 № of participants: 132 (2 RCTs) Ventilation tubes vs myringotomy | RR 1.22 [0.59, 2.53] | NR | Very low Downgraded: risk of bias, inconsistency |
Disease‐specific quality of life Ventilation tubes vs myringotomy | no estimate extracted | NR | No studies |
Presence/persistence of OME *Ventilation tubes versus laser myringotomy, randomised by ear (6 months ‐ medium‐term) Assumed CC of 0.5 № of participants: 272 (1 RCT) Ventilation tubes vs myringotomy | OR 0.27 [0.19, 0.38] | NR | Very low Downgraded: imprecision |
Adverse event: persistent perforation Range of Ventilation tubes vs myringotomy | no estimate extracted | NR | Moderate Downgraded: risk of bias, imprecision, inconsistency |