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The Role of Diet in Tympanostomy Tube Otorrhea
Kavita Dedhia1,2, Alyssa Tindall3, Jillian Karpink2
1Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Insights
Children with higher caloric intake are more likely to experience multiple ear infections after tympanostomy tube placement (TTP). This suggests diet quality may influence outcomes for children with TTP and tympanostomy tube otorrhea (TTO).
Area of Science:
- Pediatric Otolaryngology
- Pediatric Nutrition
- Epidemiology of Childhood Illnesses
Background:
- Tympanostomy tube placement (TTP) is a common procedure for recurrent otitis media.
- Tympanostomy tube otorrhea (TTO) is a frequent complication following TTP.
- The role of nutritional factors in TTO development is not well understood.
Purpose of the Study:
- To investigate the association between diet quality and the occurrence of tympanostomy tube otorrhea (TTO) in children.
- To evaluate if total caloric intake influences the risk of TTO in children with tympanostomy tube placement (TTP).
Main Methods:
- A 3-day 24-hour diet recall was used to assess dietary intake in children aged 2-6 years.
- Children with TTP performed 6 months to 2 years prior were included.
- Total caloric intake was measured by percent estimated energy rate (%EER), with TTO as the primary outcome.
Main Results:
- Children with average or high caloric intake (%EER) had significantly higher odds of experiencing more than one TTO episode.
- Odds ratios for >1 TTO episode were 4.6 (95% CI: 1.4, 15.6) for average intake and 5.7 (95% CI: 1.5, 22.1) for high intake.
- Most children had adequate intake of carbohydrates and fats but less than recommended vitamin D.
Conclusions:
- Higher total daily caloric intake is associated with an increased likelihood of multiple TTO episodes.
- Children with typical or high caloric intake are 5-6 times more likely to have recurrent TTO compared to those with low intake.
- Dietary intake, specifically caloric consumption, may play a role in the development of TTO post-TTP.
Objective:
The objective of this study was to evaluate the role of diet quality in children with tympanostomy tube placement (TTP) complicated by tympanostomy tube otorrhea (TTO).
Study Design:
Three-day 24-hour diet recall.
Setting:
Tertiary care medical center.
Methods:
Children between the ages of 2 to 6 years old with TTP performed 6 months to 2 years prior to enrollment were included. Children with a history of Down syndrome, cleft palate, craniofacial syndromes, known immunodeficiency, g-tube dependent, or a non-English speaking family were excluded. The primary outcome variable was TTO. The primary predictor was total caloric intake measured by percent estimated energy rate (%EER).
Results:
A total of 120 families completed the 3-day diet recall. The median age was 27 months (interquartile range: 7.9-68.5), with 57% male sex. Most children reported dietary intake within the recommended range percent intake for carbohydrates and fat and less than recommended range for percent vitamin D. Within this cohort 63 (52.5%) participants had >1 TTO episode and 57 (47.5%) 1 TTO episode. Children with an EER% that was average or high were at higher odds of >1 TTO episodes compared to participants with a low EER% with ORs of 4.6 (95% confidence interval [CI]: 1.4, 15.6) and 5.7 (95% CI: 1.5, 22.1) respectively.
Conclusion:
Children with a typical or high total daily caloric intake are approximately 5 to 6 times more likely to have multiple TTO episodes compared to those with low intake.
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