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Myringotomy and tympanostomy tube placement in children with sickle cell disease
Khoa D Tran1, Izabela A Koprowska, Sreedhar Rao
1Department of Otolaryngology, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Box 126, Brooklyn 11203-2098, USA. kdtran2004@yahoo.com
Insights
Children with sickle cell disease (SCD) have a lower rate of myringotomy and tube placement (M&T) than the general population. SCD type or severity did not predict the need for M&T insertion in this study.
Area of Science:
- Pediatric Hematology
- Otolaryngology
- Epidemiology
Background:
- Sickle cell disease (SCD) is a genetic blood disorder affecting millions worldwide.
- Recurrent otitis media and its complications are common in children.
- Myringotomy and tube placement (M&T) is a standard procedure for managing recurrent otitis media.
Purpose of the Study:
- To determine the event rate of myringotomy and tube placement (M&T) in pediatric patients with sickle cell disease (SCD).
- To compare the M&T event rate in children with SCD to historical control groups.
- To investigate if SCD type or severity influences the need for M&T.
Main Methods:
- A retrospective review of 449 children with confirmed SCD followed for a mean of 6.13 years.
- Identification of M&T procedures through ICD codes and hematology databases.
- Analysis of medical records for M&T event rates and patient characteristics.
Main Results:
- Eight out of 449 children with SCD underwent M&T.
- The event rate for M&T insertion was 0.29 per 100 person-years (95% CI: 0.15, 0.58).
- SCD type (hemoglobin SC vs. SS) and severity were not predictive of M&T need.
Conclusions:
- Children with SCD do not have an increased rate of M&T insertion compared to the general population.
- The event rate for M&T in pediatric SCD patients is lower than in historical controls.
- SCD characteristics do not predict the requirement for M&T procedures.
Objective:
To assess the event rate of myringotomy and tube placement (M&T) in the pediatric patient population with sickle cell disease (SCD).
Methods:
Four hundred and forty-nine children with confirmed SCD have been followed over a period of 11.5 years at two hospital-based pediatric hematology and otolaryngology offices, and three tertiary care hospitals. Children with SCD who had undergone M&T were identified via computer search of International Classification of Diseases codes by the medical records departments of the three hospitals, and from two databases of the hematology offices. The inpatient and outpatient medical records of all children identified were reviewed.
Results:
For the 449 patients, mean duration of SCD follow-up was 6.13 +/- 3.36 years. Of these, eight patients (four boys, four girls, mean age 9 +/- 3.5 years; four patients had hemoglobin SC disease, and four patients had sickle cell anemia type SS) underwent M&T. Two children met criteria for severe SCD. The event rate for M&T insertion was 0.29/100 person-years, 95% CI (0.15, 0.58).
Conclusions:
The event rate for M&T in children with SCD, compared to a historical control group, is lower than that of the general population. Type and severity of SCD were not predictive of the need for tube insertion. Children with sickle cell disease do not have an increased rate of M&T insertion.
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