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Tympanostomy in young children with recurrent otitis media. A long-term follow-up study
H Valtonen1, Y Qvarnberg, J Nuutinen
1Department of Otorhinolaryngology, Jyväskylä Central Hospital, Finland.
Insights
Tympanostomy tube insertion is a safe procedure for young children experiencing recurrent acute otitis media (RAOM) or otitis media with effusion (OME). Parents should be informed about potential otorrhoea and re-insertion needs, particularly for OME cases.
Area of Science:
- Pediatric Otolaryngology
- Otorhinolaryngology
- Medical Device Technology
Background:
- Recurrent acute otitis media (RAOM) and otitis media with effusion (OME) are common conditions in young children.
- Ventilation tubes are frequently used to manage these middle ear conditions.
- Long-term outcomes and potential complications of ventilation tube insertion require ongoing investigation.
Purpose of the Study:
- To evaluate the safety and efficacy of ventilation tube insertion in children aged five to 16 months.
- To assess the incidence of complications, re-insertion rates, and long-term outcomes.
- To compare outcomes between children with RAOM and OME.
Main Methods:
- Prospective study of 305 children (five to 16 months) treated with Shah vent Teflon tubes.
- Follow-up monitoring for five years.
- Analysis of ventilation periods, re-tympanostomy rates, adenoidectomy, mastoidectomy, and otorrhoea episodes.
Main Results:
- The study included 281 children, with an average ventilation period of 15.4 months for the first tube insertion.
- Re-tympanostomy with adenoidectomy occurred in 35.2% of ears; mastoidectomy for otorrhoea in 1.1%.
- OME patients had higher risks of post-tympanostomy otorrhoea, increased tube extrusion, and need for re-insertion compared to RAOM patients.
Conclusions:
- Early tympanostomy tube insertion is a safe procedure for young children with RAOM or OME.
- Post-tympanostomy otorrhoea and recurrent disease necessitate careful parental counseling regarding potential re-insertions, especially in OME cases.
Abstract:
A total of 305 children, five to 16 months of age, were treated from 1983-1984 with ventilation tubes-Shah vent Teflon tube-inserted under local anaesthesia for recurrent acute otitis media (RAOM) or otitis media with effusion (OME). The final study group comprised 281 children (92.1 per cent) monitored prospectively for five years, 185 in the OME-group and 96 in the RAOM-group. For the first insertion of tubes the average ventilation period was 15.4 months. Re-tympanostomy, with adenoidectomy simultaneously at the first time was performed in 99 ears (35.2 per cent); once in 27.0 per cent, twice in five per cent, and three times in 3.2 per cent. Mastoidectomy due to otorrhoea was performed in three ears (1.1 per cent). The children in the OME-group were at higher risk of repeated post-tympanostomy otorrhoea episodes than children in the RAOM-group. These episodes of otorrhoea during the first insertion of ventilation tubes significantly increased both the tube extrusion rate and the need for subsequent re-tympanostomies. No major complications were caused by the tympanostomy procedure as such. It is concluded that early tympanostomy is a safe procedure in young children with RAOM or OME. However, parents should be carefully informed of risks of post-tympanostomy otorrhoea and recurrent disease after insertion of ventilation tubes necessitating subsequent tube insertion, especially in children with OME.