Recurrent tube insertion for chronic otitis media with effusion in children over 6 years

Area of Science:

• Pediatric Otolaryngology
• Clinical Pediatrics

Background:

• Chronic otitis media with effusion (COME) is common in children.
• Pressure-equalizing tube (PET) insertion is a standard treatment for persistent COME.
• Identifying factors associated with recurrent COME requiring multiple interventions is clinically important.

Purpose of the Study:

• To determine the clinical characteristics of children over 6 years old with COME requiring pressure-equalizing tube (PET) insertions.
• To compare characteristics of children undergoing single versus multiple PET insertions.

Main Methods:

• Retrospective chart review of children aged 6+ undergoing PET insertion for COME between 2000-2009.
• Categorization into single PET insertion group and ≥ 2 PET insertions group.
• Comparative analysis of clinical characteristics between the two groups.

Main Results:

• 290 children met inclusion criteria; 54.5% required ≥ 2 PET insertions.
• Children with ≥ 2 PET insertions had higher rates of tonsillectomy/adenoidectomy (65.2% vs 53.8%, p<0.05).
• Asthma, trisomy 21, and cleft palate were significantly more prevalent in the ≥ 2 PET group (p<0.001, p<0.01, p<0.05 respectively).

Conclusions:

• Children over 6 requiring multiple PET insertions for COME show increased co-occurrence of tonsillectomy and adenoidectomy.
• Asthma, trisomy 21, and cleft palate are identified as risk factors for COME necessitating repeated PET insertions.