Audiometric Testing Guideline Adherence in Children Undergoing Tympanostomy Tubes: A Population-Based Study
Jason A Beyea1, Emily Rosen2, Trina Stephens1
11 Department of Otolaryngology, Hotel Dieu Hospital, Kingston Health Sciences Centre, Queen's University School of Medicine, Kingston, ON, Canada.
Summary
Hearing tests before and after tympanostomy tube surgery in children are increasing but still fall short of guidelines. Younger surgeons show better adherence to pediatric hearing test recommendations.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Health Services Research
Background:
- Tympanostomy tube (TT) insertion is a common pediatric ambulatory surgery.
- Clinical Practice Guidelines (CPGs) recommend hearing testing for all pediatric TT candidates.
- Adherence to these guidelines is crucial for optimal pediatric hearing health management.
Purpose of the Study:
- To assess the rates of audiometric testing in children undergoing tympanostomy tube procedures.
- To evaluate trends in pre- and post-operative hearing tests over time.
- To identify factors influencing adherence to hearing testing guidelines.
Main Methods:
- Retrospective population-based cohort study in Ontario, Canada.
- Inclusion of 316,599 bilateral TT procedures in patients 12 years or younger (1993-2016).
- Primary outcomes: percentage of patients with hearing tests within 1 year pre- or post-surgery.
Main Results:
- Preoperative hearing tests increased from 55.7% to 74.9%; postoperative from 42.2% to 68.9%.
- Younger surgeons showed higher CPG adherence (RR 1.22).
- No significant increase in preoperative testing post-CPG introduction in 2013; wide regional variation (26.1%-83.5%).
Conclusions:
- Audiometric testing rates are increasing but remain below CPG recommendations.
- Challenges include audiology service access, parental preferences, and need for continuing medical education.
- Further efforts are needed to ensure all pediatric TT candidates receive recommended hearing evaluations.
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