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Epidemiology of common otologic surgical procedures in pediatric patients: A population-based birth cohort study
Mao-Che Wang1, Chia-Huei Chu2, Ying-Piao Wang3
1Department of Otolaryngology Head Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, School of Medicine and Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
Insights
Ventilation tube insertion (VTI) is the most common pediatric otologic surgery, typically for children aged 4-5. Tympanoplasty and mastoidectomy are less common but also analyzed in this study.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Epidemiology
Background:
- Pediatric otologic surgery incidence and age distribution are not well-defined.
- Ventilation tube insertion (VTI) is recognized as the most common procedure.
Purpose of the Study:
- To examine the incidence and age distribution of VTI, tympanoplasty, and mastoidectomy in a pediatric population.
- To provide an overview of the role of these otologic surgeries in children.
Main Methods:
- Population-based birth cohort design using Taiwan's national health insurance research database.
- Analysis of patients born in 2000-2001 who underwent VTI, tympanoplasty, or mastoidectomy between 2000-2013.
Main Results:
- Cumulative incidence: VTI (0.41%), tympanoplasty (0.02%), mastoidectomy (0.025%).
- VTI most common in 4-5 year olds; tympanoplasty in those >5 years (30.7% with prior VTI, mean interval 5.18 years).
- Mastoidectomy most common in 2-9 year olds.
Conclusions:
- VTI is the predominant pediatric otologic surgery, particularly for 4-5 year olds.
- Tympanoplasty is more frequent in older children, often following VTI.
- Children with cleft palate and metabolic disorders show higher susceptibility to otologic surgical procedures.
Objective:
It is generally recognized the most common pediatric otologic surgical procedure is ventilation tube insertion (VTI). Tympanoplasty and mastoidectomy are more frequently performed on adults. In this study we examined the incidence and age distribution of these procedures by use of a population-based birth cohort design, in order to provide an overall view of the role of these procedures in the pediatric population.
Materials And Methods:
We used the national health insurance research database in Taiwan. We retrieved data on all patients born in the years 2000 and 2001, subsequently underwent VTI, tympanoplasty or mastoidectomy from 2000 to 2013. The incidence and age distribution of these procedures were analyzed.
Results:
The cumulative incidence of VTI, tympanoplasty, and mastoidectomy was 0.41%, 0.02% and 0.025%, respectively. VTI were more often performed on children 4 or 5 years of age. Tympanoplasties are frequently done on children older than 5, and 30.7% of them had earlier VTI. The time interval from VTI to tympanoplasty was 5.18 ± 2.27 years (mean ± SD). Mastoidectomies are more often performed on children from 2 to 9 years of age.
Conclusions:
VTI was the most frequent otologic surgery for the pediatric population, and was more often performed on children 4-5 years old. Also, tympanoplasty is more frequently performed on children older than 5, and a third of them had prior VTI. Overall, the time interval from VTI to tympanoplasty was 5.18 years. Furthermore, children with cleft palate and congenital metabolic disorder were more prone to otologic surgical procedures.
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