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Prospective long-term follow-up after grommet insertion: Hearing and functional health outcomes in children
Michelle A Pokorny1, Wiremu MacFater2, Inbal Meshulam-Weiss3
1Health NZ/Te Whatu Ora, Counties Manukau, ORL and Audiology Department, Auckland, New Zealand; The University of Auckland Faculty of Medical and Health Sciences, School of Population Health, Section of Audiology, New Zealand; Eisdell Moore Centre for Hearing and Balance Research, University of Auckland, Auckland, New Zealand.
Insights
Two years post-grommet surgery, many children experience hearing loss and functional health issues, with Māori children disproportionately affected. Standard follow-up care needs improvement to address these persistent problems.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Public Health
Background:
- Grommet insertion is a common procedure for childhood ear infections.
- Standard follow-up care typically involves discharge to General Practitioner (GP) or a brief Ear Nose and Throat (ENT) clinic appointment.
- The long-term effectiveness of standard follow-up on hearing and functional health outcomes requires further investigation.
Purpose of the Study:
- To evaluate hearing levels in children two years after routine grommet surgery.
- To assess functional health outcomes in children two years after grommet insertion.
- To identify disparities in outcomes, particularly for Māori children.
Main Methods:
- A prospective cohort study involving 89 children (average age 7.98 years) was conducted.
- Audiological assessments were performed two years post-surgery.
- Functional health was measured using parent-reported OMQ20 questionnaire responses.
Main Results:
- Over half of the children (51.7%) had hearing loss in at least one ear; 31.5% had bilateral hearing loss.
- Māori children showed significantly higher odds (OR 5.491, p=0.003) of bilateral hearing loss after controlling for covariates.
- Bilateral hearing loss significantly predicted poorer functional health status (p<0.001).
Conclusions:
- Current standard follow-up care post-grommet insertion appears insufficient for managing children's hearing and functional health.
- Māori children face a disproportionate burden of hearing loss and functional health issues.
- Individualized follow-up strategies are crucial to mitigate inequities in outcomes after grommet surgery.
Objectives:
To assess hearing levels and functional health outcomes of children two years after routine grommet surgery with standard care follow-up (discharge to General Practitioner (GP) care or Ear Nose and Throat (ENT) clinic appointment at 4-8 weeks).
Methods:
Prospective cohort study of 89 children (average age of 7.98 years) recalled for audiological assessment 2 years after grommet surgery in a large ENT outpatient service in South Auckland, New Zealand. Functional health was assessed using parent-reported responses to the OMQ20 questionnaire.
Results:
46 (51.7 %) children had hearing loss in at least one ear with 28 (31.5 %) children having bilateral hearing loss. Māori children had statistically higher odds compared to non-Māori children (odds ratio 5.491, p = .003) to have bilateral hearing loss after controlling for age, household deprivation, gender, season, and mode of follow-up. Most parents reported concerns with their child's hearing, speech, attention-seeking behaviours, and nasal symptoms, but not ear problems. Bilateral hearing loss (p < .001) was found to significantly predict functional health status (total OMQ20 score).
Conclusions:
The high prevalence of hearing loss and functional health concerns suggest that the standard follow-up care is not adequately managing children after routine grommet insertion. Māori children are disproportionately impacted, and post-grommet follow-up schedules must consider individualised approaches to address these inequities in outcomes.
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