Hearing thresholds and tympanic membrane sequelae in children managed medically or surgically for otitis media with
Robert Stenstrom1, I Barry Pless, Philippe Bernard
1Department of Emergency Medicine, St Paul's Hospital, Vancouver, British Columbia, Canada. rstenstrom@providencehealth.bc.ca
Insights
Long-term use of ventilation tubes in children with otitis media with effusion is linked to higher hearing thresholds and more tympanic membrane abnormalities. These findings highlight potential risks associated with ventilation tube treatment for recurrent ear infections.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Medical Technology
Background:
- Recurrent otitis media with effusion (OME) is common in children.
- Ventilation tubes (VT) are frequently inserted to treat OME.
- Long-term sequelae of VT insertion require further investigation.
Purpose of the Study:
- To assess the long-term effects of ventilation tube insertion on hearing.
- To evaluate tympanic membrane abnormalities after VT treatment for OME.
- To compare outcomes between medical and surgical OME treatments.
Main Methods:
- Prospective cohort study of children aged 8-16 years.
- Follow-up 6-10 years after initial randomized controlled trial.
- Evaluations included audiometry, tympanometry, otomicroscopy, and questionnaires.
Main Results:
- Tympanic membrane abnormalities were significantly higher in VT subjects (81%) vs. medical subjects (19%).
- Hearing thresholds were elevated by 2.1-8.1 dB in children treated with VT.
- Relative risk of abnormalities was 4.4 in VT subjects.
Conclusions:
- VT insertion for OME is associated with increased long-term hearing loss.
- VT treatment leads to a higher incidence of tympanic membrane pathology.
- Children treated with VT show poorer long-term audiological and structural outcomes.
Objective:
To determine the long-term effects of ventilation tube insertion on hearing thresholds and tympanic membrane pathologic abnormalities in children with otitis media with effusion.
Design:
Prospective cohort study.
Setting:
Tertiary care children's hospital, otorhinolaryngology and audiology service.
Participants:
Patients aged 8 to 16 years who participated in a randomized controlled trial of medical vs surgical (ventilation tube [VT]) treatment for recurrent otitis media with effusion at ages 2.5 to 7 years.
Main Outcome Measures:
Hearing thresholds and tympanic membrane sequelae.
Methods:
One hundred thirteen of 125 children who had participated in the trial underwent blinded audiometric, tympanometric, otomicroscopic, and parental questionnaire evaluation 6 to 10 years following the trial. Thirty of 57 [corrected] medical subjects received ventilation tubes and 18 of 56 [corrected] VT subjects received more than 1 set of tubes. To evaluate sequelae risk associated with ventilation tubes independent of disease severity, we compared 27 medical subjects who never received ventilation tubes and 38 subjects randomized to VT who only received 1 set of tubes.
Results:
Tympanic membrane pathologic abnormalities were present in 81% of VT subjects and 19% of medical subjects (relative risk, 4.4; 95% confidence interval, 2.2-9.9). Hearing thresholds were 2.1 to 8.1 dB higher in subjects treated with tubes (P = .005).
Conclusions:
In children who were candidates for ventilation tube insertion randomly assigned to receive medical or VT treatment for otitis media with effusion, elevated hearing thresholds and tympanic membrane pathologic abnormalities were more common in VT subjects 6 to 10 years after insertion.
Related Concept Videos
01:14Myocarditis III: Medical Management
01:18Endocarditis III: Medical Management
01:17Pericarditis III: Medical Management
01:31Hearing
01:28Pleural Effusion II: Symptoms and Management
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
01:14Assessing Body Temperature - Tympanic membrane
Step 1: Begin by practicing good hand hygiene to prevent the transmission of microorganisms.
Step 2: Turn on the thermometer and wait until the ready sign appears on the screen to ensure accurate measurement.
Step 3: Slide the probe cover in place to prevent cross-contamination.
Step 4: Instruct the patient to tilt their head to the side for comfort and check for cerumen...