Abordaje y manejo de pacientes pediátricos que requieren tubos timpánicos. Estudio basado en manejo por Otorrinolaringólogos en Costa Rica para el 2023
Fecha
2023
Tipo
tesis
Autores
Elizondo Ureña, Edgar Alfonso
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Resumen
El presente trabajo tiene como objetivo describir el abordaje y manejo de pacientes pediátricos que requieren colocación de tubos timpánicos a nivel de otorrinolaringólogos de Costa Rica para el 2023, basándose en una encuesta con los aspectos más importantes a tomar en cuenta a la hora de manejar y abordar dichos pacientes.
Se hace una revisión bibliográfica amplia de las principales guías de manejo de tubos timpánicos y de los aspectos referentes al manejo y abordaje de pacientes pediátricos que requieren colocación de tubos timpánicos en contexto de otitis media con efusión.
Métodos: Se utilizó un cuestionario en línea a 108 otorrinolaringólogos de Costa Rica inscritos y activos en el Colegio de Médicos y Cirujanos, tanto a nivel privado como público. La encuesta incluye variables que se relacionan al abordaje y manejo de pacientes pediátricos que requieren tubos timpánicos como indicaciones quirúrgicas, métodos diagnóstico, valoración prequirúrgica, variaciones clínicas a tomar en cuenta previo a la cirugía y acciones referentes al manejo postquirúrgico.
Resultados: Se obtuvo respuesta de 52 otorrinolaringólogos. Con respecto al abordaje prequirúrgico, y postquirúrgico de pacientes que requieren colocación de tubos timpánicos. La mayoría de los otorrinolaringólogos cumplen con las recomendaciones de las guías internacionales. En cuanto a manejo postquirúrgico principalmente en lo relacionado a cuidados del oído contra el agua, es en donde se encuentra la mayor heterogeneidad y discordancia entre los otorrinolaringólogos en Costa Rica con respecto a las guías de manejo sugeridas.
Conclusiones: Existe gran variabilidad en la práctica en cuanto al manejo de pacientes que requieren colocación de tubos timpánicos, sin embargo, la mayoría tiene conceptos claros del abordaje prequirúrgico y de los criterios a tomar en cuenta en el diagnóstico e indicaciones de tubos timpánicos. En cuanto al manejo postquirúrgico se deberán mejorar algunas recomendaciones de las guías en búsqueda de mejora en cuanto al manejo de pacientes a los que se les colocó tubos timpánicos.
Abstract The present work aims to describe the approach and management of pediatric patients requiring tympanostomy tube placement at the level of otorhinolaryngologists in Costa Rica by 2023, based on a survey with the most important aspects to consider when managing and approaching such patients. A wide bibliographic review of the main tympanostomy tube management guidelines and of the aspects related to the management and approach of pediatric patients requiring tympanostomy tube placement in the context of Otitis media with effusion was carried out. Methods: We used an online questionnaire to 108 otorhinolaryngologists in Costa Rica registered and active in the College of Physicians and Surgeons, both at private and public level. The survey includes variables related to the approach and management of pediatric patients requiring tympanic tubes, such as surgical indications, diagnostic methods, pre-surgical evaluation, clinical variations to be considered prior to surgery and actions related to post-surgical management. Results: A response was obtained from 52 otorhinolaryngologists. Regarding preoperative and post-surgical approach of patients requiring tympanostomy tube placement. Most otolaryngologists complied with the recommendations of international guidelines. Regarding postoperative management, mainly related to ear care, we found the greatest heterogeneity among otolaryngologists in Costa Rica and discordance with respect to the suggested management guidelines. Conclusions: There is great variability in practice regarding the management of patients requiring tympanostomy tube placement, however, most have clear concepts of the preoperative approach and the criteria to be considered in the diagnosis and indications for tympanostomy tubes. Regarding postoperative management, some recommendations of the guidelines should be improved to improve the management of patients who have had tympanostomy tubes placed.
Abstract The present work aims to describe the approach and management of pediatric patients requiring tympanostomy tube placement at the level of otorhinolaryngologists in Costa Rica by 2023, based on a survey with the most important aspects to consider when managing and approaching such patients. A wide bibliographic review of the main tympanostomy tube management guidelines and of the aspects related to the management and approach of pediatric patients requiring tympanostomy tube placement in the context of Otitis media with effusion was carried out. Methods: We used an online questionnaire to 108 otorhinolaryngologists in Costa Rica registered and active in the College of Physicians and Surgeons, both at private and public level. The survey includes variables related to the approach and management of pediatric patients requiring tympanic tubes, such as surgical indications, diagnostic methods, pre-surgical evaluation, clinical variations to be considered prior to surgery and actions related to post-surgical management. Results: A response was obtained from 52 otorhinolaryngologists. Regarding preoperative and post-surgical approach of patients requiring tympanostomy tube placement. Most otolaryngologists complied with the recommendations of international guidelines. Regarding postoperative management, mainly related to ear care, we found the greatest heterogeneity among otolaryngologists in Costa Rica and discordance with respect to the suggested management guidelines. Conclusions: There is great variability in practice regarding the management of patients requiring tympanostomy tube placement, however, most have clear concepts of the preoperative approach and the criteria to be considered in the diagnosis and indications for tympanostomy tubes. Regarding postoperative management, some recommendations of the guidelines should be improved to improve the management of patients who have had tympanostomy tubes placed.
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Palabras clave
pacientes pediátricos, tubos timpánicos, manejo por Otorrinolaringólogos, PEDIATRÍA