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Tympanostomy tube sequelae in children with otitis media with effusion: a three-year follow-up study
Maria Beatriz Rotta Pereira1, Denise Rotta Ruttkay Pereira, Sady Selaimen da Costa
1Federal University of Rio Grande do Sul.
Insights
Tympanostomy tube insertion for ear infections is common. Otorrhea (ear discharge) is the most frequent complication, but concurrent adenoidectomy may reduce its occurrence.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Surgical Complications
Background:
- Tympanostomy tube (TT) insertion is a frequent otolaryngologic procedure.
- Potential complications include otorrhea, tympanosclerosis, retraction, perforation, and cholesteatoma.
Purpose of the Study:
- To determine the incidence and types of sequelae/complications following tympanostomy tube insertion in children.
- To analyze factors influencing TT outcomes in children with recurrent or chronic otitis media with effusion.
Main Methods:
- Prospective cohort study involving 75 children (150 ears) aged 11 months to 10 years.
- Follow-up duration extended up to 38 months post-TT insertion.
Main Results:
- Otorrhea occurred in 47.3% of ears, retractions in 39.7%, and tympanosclerosis in 23.3%.
- Younger age at initial tube placement correlated with a higher need for a second set of tubes.
- TT insertion with adenoidectomy was linked to fewer otorrhea episodes.
Conclusions:
- Otorrhea is the most common complication after tympanostomy tube insertion.
- Adenoidectomy may decrease otorrhea episodes. Tubes remain longer in ears with more otorrhea.
- Approximately one in six patients may require a second set of ventilation tubes.
Unlabelled:
Tympanostomy tube (TT) insertion is one of the most frequently performed procedures in otolaryngology. Otorrhea, tympanosclerosis, retraction, perforation, and cholesteatoma are complications reported in the literature after its application.
Aim:
To determine the incidence and the type of TT insertion sequelae/complications in children presenting with recurrent otitis media and chronic otitis media with effusion undergoing myringotomy and tube placement.
Study Design:
Prospective cohort study.
Material And Method:
A total of 75 children (150 ears) aged 11 months to 10 years were regularly followed up for up to 38 months after TT insertion.
Results:
Incidence of sequelae/complications: otorrhea--47.3% of the ears; perforation--2.1%; retractions--39.7%; tympanosclerosis--23.3%. Average length of stay: 12.13 months. Mean age at initial tube placement of children not requiring a second set of tubes = 35.9 months and mean age at initial tube insertion of children requiring an additional set of tubes = 25.6 months (P = 0.04). TT stayed longer in the ears that had more episodes of otorrhea (P = 0.01). TT insertion with adenoidectomy was associated with a smaller number of otorrhea episodes (P = 0.02)
Conclusions:
Otorrhea was the most frequently found complication. TT placement with adenoidectomy was associated with fewer otorrhea episodes. TT extruded later in those ears that had more episodes of otorrhea. Younger age at the time of the initial tube placement is associated with higher incidence of additional tube placement. One in six patients will probably require a second set of ventilation tubes.
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