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Risk Factors for Multiple Tympanostomy Tube Placements in Children: Systematic Review and Meta-Analysis.

Alexander N Goel1, Aisosa Omorogbe1, Alyssa Hackett1

  • 1Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

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Summary

Approximately 24% of children require repeat tympanostomy tube (TT) placements, with craniofacial disease being a key predictor. Concurrent adenoidectomy and long-term tubes can reduce the need for repeat tympanostomy tube surgery.

Keywords:
Otits mediatympanostomy tube

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Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Epidemiology

Background:

  • Tympanostomy tubes (TT) are commonly placed in children to manage otitis media.
  • Understanding the factors influencing repeat TT placements is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

  • To determine the incidence of multiple tympanostomy tube (TT) placements in children.
  • To identify predictors associated with repeat TT (r-TT) procedures.

Main Methods:

  • A systematic review and meta-analysis of studies reporting risk factors for repeat TT placements.
  • Searches were conducted in PubMed, EMBASE, and Cochrane Library databases.
  • Data were synthesized using a random-effects model, adhering to PRISMA guidelines.

Main Results:

  • Out of 290,897 children, 24.1% received at least two TT placements and 7.5% received three or more.
  • Craniofacial disease (OR 5.13) was the strongest predictor for repeat TTs.
  • Younger age at initial placement, shorter tube retention, concurrent adenoidectomy, and long-term tubes were significant factors.

Conclusions:

  • Nearly one in four children undergo repeat tympanostomy tube insertions.
  • Concurrent adenoidectomy and long-term tubes decrease the incidence of repeat TTs.
  • Identifying at-risk children can enhance counseling and guide follow-up strategies.