Mechanical ventilation and middle ear effusions among tracheostomy-dependent children

Area of Science:

• Pediatric Otolaryngology
• Respiratory Medicine
• Developmental Pediatrics

Background:

• Middle ear effusion (MEE) is common in children.
• Tracheostomy and mechanical ventilation are associated with increased respiratory and potentially otologic complications.
• Understanding MEE incidence in this specific population is critical for early intervention.

Purpose of the Study:

• To determine the cumulative 24-month incidence of middle ear effusion (MEE) in children dependent on tracheostomy and ventilatory support.
• To identify risk factors associated with MEE development in this cohort.

Main Methods:

• Prospective longitudinal cohort study of children under 2 years with tracheostomy.
• Inclusion criteria: tertiary care hospital, 2015-2020, at least one tympanometry exam.
• MEE defined by tympanometry; mechanical ventilation status recorded.

Main Results:

• 56.5% of children developed MEE within 24 months post-tracheostomy.
• Children on mechanical ventilation had a 2.97-fold increased risk of MEE (74.0% vs. 31.2%).
• Ventilator dependence significantly predicted MEE presence (OR: 2.34) after controlling for confounders.

Conclusions:

• Mechanical ventilation is a significant predictor of MEE in tracheostomy-dependent children.
• Clinicians must assess for MEE in this population to prevent adverse speech and language outcomes.
• Early identification and management of MEE can improve developmental trajectories.