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Second tympanostomy tube placement in children with recurrent acute otitis media

Phillip Huyett1, Joshua J Sturm2, Amber D Shaffer3

  • 1Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.

The Laryngoscope
|October 10, 2017
PubMed

Insights

The rate of a second bilateral myringotomy and tympanostomy tube placement (BMT) for recurrent acute otitis media (RAOM) was 15.2%. Younger age, family history, and intraoperative middle ear fluid predict the need for a second BMT.

Area of Science:

  • Otolaryngology
  • Pediatric Otitis Media Research
  • Surgical Outcomes

Background:

  • Recurrent acute otitis media (RAOM) is a common childhood condition requiring medical intervention.
  • Bilateral myringotomy and tympanostomy tube (BMT) placement is a standard treatment for RAOM.
  • Understanding predictors for repeat procedures is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

  • To determine the incidence of a second BMT in children treated for RAOM.
  • To identify clinical and intraoperative factors associated with the need for a second BMT.

Main Methods:

  • Retrospective review of medical charts for 600 children who underwent initial BMT for RAOM between 2012 and 2014.
  • Analysis of patient demographics, family history, preoperative findings, and intraoperative observations.
  • Statistical analysis to identify predictors of requiring a second BMT.

Main Results:

  • The overall rate of a second BMT was 15.2%, occurring a median of 1.58 years after the initial procedure.
  • Younger age at initial BMT (1.06 years) and a positive family history of RAOM/BMT were significant predictors (OR: 1.67).
  • Intraoperative identification of middle ear fluid, particularly bilateral fluid (OR: 2.25), significantly increased the likelihood of needing a second BMT.

Conclusions:

  • Younger age, family history of RAOM/BMT, and intraoperative middle ear effusions are key predictors for requiring a second BMT in children with RAOM.
  • The rate of second BMT for RAOM in this cohort is lower than reported for broader indications.
  • These findings can aid in patient selection and counseling for initial tympanostomy tube placement.
Abstract

Keywords:
Recurrent acute otitis mediabilateral myringotomy with tubespediatric otolaryngologytympanostomy tube

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