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Tracking tympanostomy tube outcomes in pediatric patients with otitis media using an electronic database
Mallory B O'Niel1, Laura D Cassidy2, T Roxanne Link3
1Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226, USA.
Insights
A new database tracks children with otitis media (OM), showing surgical outcomes and low complication rates. This research supports better treatment algorithms for this common ear infection.
Area of Science:
- Pediatric Otolaryngology
- Epidemiology of Ear Infections
Background:
- Otitis media (OM) is a common childhood diagnosis requiring frequent surgical intervention.
- Long-term outcomes and comparative data for OM surgical management are essential.
Purpose of the Study:
- To implement and review a database for children with otitis media (OM).
- To facilitate comparative outcomes and long-term prospective follow-up of surgical outcomes.
- To review presenting symptoms, risk factors, tympanostomy tube outcomes, complications, and need for further procedures.
Main Methods:
- A web-based customized database was developed to enroll patients diagnosed with OM.
- Database fields include demographics, physical exam findings, risk factors, intervention, and long-term outcomes.
- Major surgical complications such as tympanic membrane perforation, retained tubes, chronic otorrhea, and cholesteatoma formation were measured.
Main Results:
- 634 unique patients were prospectively enrolled, with 544 tympanostomy tubes followed to extrusion.
- High prevalence of OM risk factors noted: 63% in day care, 26% with a sibling requiring tubes.
- Low complication rates observed: 1% perforations, 2.6% retained tubes, 0.7% early extrusion, 0.56% cholesteatoma.
Conclusions:
- Long-term, outcome-driven investigations for OM surgical management are necessary due to disease prevalence.
- The database represents the largest prospective cohort, demonstrating short-term quality of life improvements with low long-term complication rates.
- This ongoing study provides data for treatment algorithms, procedure justification, and risk factor modification.
Objective:
To implement and review a database for children with a diagnosis of otitis media (OM) to facilitate comparative outcomes and long-term prospective follow up of surgical outcomes. Specific aim is to review presenting symptoms, risk factors, tympanostomy tube outcomes and complications, and need for further procedures.
Methods:
A web-based customized database was constructed to universally enroll all patients seen in consultation with a diagnosis of OM. Unique database fields include demographics, physical exam findings, risk factors, intervention, and long-term outcomes. Major surgical complications measured include: tympanic membrane perforation, retained tubes, chronic otorrhea, and cholesteatoma formation.
Results:
Six hundred and thirty four unique patients have been prospectively enrolled. Five hundred and forty four tubes have been followed to extrusion. Outcomes demonstrate high prevalence of OM risk factors associated with surgical patients including: 63% in day care and 26% with a sibling requiring tympanostomy tubes. Complication rates; 1% developed perforations requiring surgical intervention, 2.6% required removal of retained tubes, 1% extruded early (<60 days), and 0.7% were surgically removed for other complications. Cholesteatoma was identified in 0.56%, all had ongoing chronic ear disease.
Conclusions:
Long-term, outcome driven investigations assessing the surgical management of OM are needed given the prevalence of this disease and the frequency of surgical intervention required. The current database represents the largest prospective cohort of patients enrolled and followed in this fashion and has generated data demonstrating a procedure associated with significant improvement in patient quality of life in the short-term with low complication rates in the long-term. This ongoing prospective investigation is providing data that have the potential to be important in treatment algorithms, procedure justification, and risk factor modification.
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