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Does passive smoking affect the outcome of grommet insertion in children?
1Department of ENT, Princess Royal University Hospital, Kent, UK. cvpraveen@doctors.org.uk
Insights
Children exposed to passive smoking, including during pregnancy, experienced shorter grommet survival and higher complication rates after ear tube surgery. This highlights the harmful effects of secondhand smoke on pediatric ear health.
Area of Science:
- Otolaryngology
- Pediatric Health
- Environmental Health
Background:
- Bilateral myringotomy with ventilation tube (grommet) insertion is a common pediatric surgical procedure.
- Recurrent secretory otitis media often necessitates grommet insertion in children.
- The impact of passive smoking on grommet insertion outcomes requires further investigation.
Purpose of the Study:
- To investigate the relationship between passive smoking exposure and the outcomes of grommet insertion in children.
- To assess the effect of parental smoking on grommet survival and complication rates.
- To evaluate the association between prenatal and postnatal passive smoke exposure and ear health outcomes.
Main Methods:
- A prospective study followed 606 children (1174 ears) undergoing grommet insertion for recurrent secretory otitis media.
- Children were monitored until grommet extrusion.
- Data collected included passive smoking exposure (prenatal and postnatal) and various surgical outcomes.
Main Results:
- Children exposed to passive smoking had a median grommet survival of 59 weeks versus 86 weeks for non-exposed children.
- Grommet extrusion rates were 36% higher at one year if both parents smoked.
- Post-extrusion myringosclerosis was significantly more common in children with parental smoking exposure.
Conclusions:
- Passive smoking exposure is linked to poorer outcomes following grommet insertion, including shorter grommet survival and increased complications.
- Children exposed to passive smoke showed higher rates of post-operative infection, attic retraction, myringosclerosis, and permanent tympanic membrane perforations.
- The findings reinforce public health recommendations regarding the detrimental effects of passive smoking on children's ear health.
Abstract:
Bilateral myringotomy with insertion of ventilation tube (grommet) is the most common surgical procedure done on children under general anaesthetic. A prospective study was conducted on children undergoing grommet insertion to ascertain any relationship between exposures of passive smoking to the outcome of grommet insertion. Six hundred and six children (with 1174 ears) who underwent grommet insertion for recurrent secretory otitis media were followed up till the grommets were extruded. Thirty-three children (65 per cent), whose mothers smoked when they were pregnant, had bilateral narrow external ear canals. The median survival rate of grommet was 59 weeks in children who were exposed to passive smoking as compared to 86 weeks for non-exposed children and the extrusion rate of grommet was 36 per cent higher at the end of one year if both parents smoked compared to the non-smoking group. Post-extrusion myringosclerosis was 64 per cent if both parents smoked and less than 20 per cent if neither parents smoked. It is concluded that post-operative infection rate, attic retraction, post-extrusion myringosclerosis and permanent perforations of tympanic membrane were more common in children exposed to passive smoking. The study provides further support to professional and governmental advice that passive smoking is harmful.
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