Risk Factors for Preoperative and Postoperative Hearing Loss in Children Undergoing Pressure Equalization Tube
Douglas Sidell1, Lisa L Hunter2, Li Lin3
1Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA douglas.sidell@cchmc.org.
Insights
Hearing loss after pressure equalization tube (PET) surgery in children is not predictable by risk factors. Continued hearing loss is linked to age, preoperative loss, and Down syndrome, highlighting the need for audiology testing.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Developmental Pediatrics
Background:
- Pressure equalization tube (PET) placement is a common pediatric surgery.
- Early management of otitis media with effusion is crucial for preventing developmental issues.
Purpose of the Study:
- To identify risk factors for persistent hearing loss after PET placement in children.
- To inform preoperative counseling and postoperative management strategies.
Main Methods:
- Retrospective analysis of electronic medical records from a tertiary care children's hospital.
- Included 3949 pediatric patients undergoing PET placement with audiometric tests.
- Multivariate logistic regression used to analyze associations between patient characteristics and hearing loss.
Main Results:
- Preoperative hearing loss was associated with low tympanometric static acoustic admittance.
- Postoperative hearing loss linked to older age, preoperative hearing loss, lower tympanometric equivalent canal volumes, and Down syndrome.
- Cranial anomalies, prematurity, allergies, and asthma were not significant risk factors.
Conclusions:
- Hearing loss in children undergoing PET surgery cannot be reliably predicted by demographic or risk factors.
- Routine hearing testing is essential for identifying surgical candidates and assessing treatment efficacy.
- Findings have implications for preoperative counseling and postoperative care.
Objective:
Pressure equalization tube (PET) placement is the most common surgical procedure performed during childhood. Current guidelines recommend more prompt management of children with otitis media with effusion who are at greater risk for speech-language and developmental problems. This study was designed to examine risk factors for continued post-PET hearing loss in a large pediatric clinical sample.
Study Design:
Retrospective analysis using the electronic medical record.
Setting:
Tertiary care children's hospital.
Subjects:
Pediatric patients undergoing PET placement between January 2009 and October 2012 who had audiometric tests.
Methods:
Demographics, patient diagnoses, and hearing loss information were extracted. Multivariate binary logistic regression models were used to identify associations between patient-specific characteristics and the presence of hearing loss.
Results:
In total, 3949 children with 4598 audiology visits were included (2357 males and 1592 females; mean age, 3.3 years), and 1272 preoperative and 3329 postoperative audiograms were performed. Using multivariate modeling, the only variable significantly associated with preoperative hearing loss was low tympanometric static acoustic admittance. Postoperative hearing loss was positively associated with patient age, preoperative hearing loss, lower tympanometric equivalent canal volumes, and Down syndrome. Other factors, including cranial/facial anomalies, low birth weight or prematurity, allergies, and asthma, were not determined to be risk factors for hearing loss.
Conclusion:
Our results support hearing testing to identify candidates for PET surgery and to determine treatment effectiveness after surgery, since hearing loss cannot be predicted on the basis of risk or demographic factors. These data have important preoperative counseling and postoperative management implications.
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