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Otitis media prone children with cystic fibrosis: A new normal
Jennifer L McCoy1, Thomas M Kaffenberger2, Tiffany S Yang3
1Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States of America.
Insights
Children with cystic fibrosis (CF) prone to otitis media requiring tympanostomy tube placement (TTP) show similar rates of tympanostomy tube otorrhea (TTO) as non-CF children. This study highlights TTO incidence in CF patients post-TTP.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Pulmonology
- Genetics and Rare Diseases
Background:
- Recurrent acute otitis media (RAOM) is common in children.
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, including the respiratory system.
- Otitis media is a frequent complication in children with CF.
Purpose of the Study:
- To investigate the incidence of tympanostomy tube otorrhea (TTO) in children with cystic fibrosis (CF) who have undergone tympanostomy tube placement (TTP).
- To compare the natural course of TTO in CF patients with the established incidence in non-CF children (21-34%).
Main Methods:
- Retrospective review of CF patients at a tertiary pediatric hospital from 2010-2019.
- Inclusion criteria identified 17 CF patients who had undergone TTP.
- Data collection included demographics, CF diagnosis, genotype, TTP history, and TTO occurrences up to 18 months post-TTP.
Main Results:
- CF diagnosed at a median age of 13 days; 82.4% had one TTP, 11.8% had two, and 5.9% had five.
- Median age at first TTP was 2 years.
- TTO occurred in 29.4% at 3 months, 35.3% at 6-9 months, and 41.2% at 12-18 months post-TTP.
Conclusions:
- CF children are more prone to severe RAOM, necessitating TTP.
- The incidence of TTO in CF children following TTP aligns with the natural history observed in the non-CF population.
- This is the first study to report TTO rates in CF patients post-TTP, confirming a similar trajectory to non-CF peers.
Objectives:
To determine if children with cystic fibrosis (CF) who are otitis media prone and treated with tympanostomy tube placement (TTP) follow the natural course of non-CF children regarding the incidence of tympanostomy tube otorrhea (TTO) (21-34%).
Methods:
All CF patients seen at a large tertiary pediatric hospital were retrospectively reviewed from 2010 to 2019. A total of 483 patients were identified and seventeen met the inclusion criteria and were included in the analysis. Data collected included demographics, CF diagnosis history including date of diagnosis and genotype, TTP notes, and otorrhea found in otolaryngology clinic and pediatrician clinic notes for up to 18 months post-TTP.
Results:
CF was diagnosed at a median age of 13 days (0 days to 6 years). In terms of surgical frequency, 14/17 (82.4%) patients had one TTP, 2/17 (11.8%) had two TTPs, and 1/17 (5.9%) had five TTPs. The median (range) age at first TTP was 2 years (3 months to 13 years). After the first TTP, TTO occurred in 5 (29.4%) patients at 3 months, 6 (35.3%) at 6 and 9 months, and 7 (41.2%) at 12 and 18 months at median (range) = 1 (0-5) otolaryngology appointments and median (range) = 0 (0-8) pediatrician appointments.
Conclusion:
To our knowledge this is the first study to report that CF children are more likely to be severely affected with recurrent acute otitis media (RAOM), to require TTP, and to exhibit a natural history of TTO commensurate with the non-CF population.
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