Temporal Trends in and Patient Characteristics Associated with Surgery for Otitis Media

Area of Science:

• Pediatric Otolaryngology
• Epidemiology of Ear Infections
• Surgical Intervention Trends

Background:

• Otitis media (OM) is a common childhood condition requiring medical or surgical management.
• Tympanostomy tube insertion (TTI) is a primary surgical intervention for recurrent or persistent OM.
• Understanding trends and patient factors influencing OM surgery is crucial for healthcare planning.

Purpose of the Study:

• To analyze temporal trends in otitis media surgery rates.
• To identify specific patient characteristics associated with tympanostomy tube insertion (TTI) and TTI with adenoidectomy (TTI-A).

Main Methods:

• Retrospective cohort study utilizing electronic health records from seven pediatric networks (2009-2022).
• Included children under 6 months at cohort entry with OM history, followed longitudinally.
• Analyzed rates of TTI and TTI-A and associated patient demographics and conditions.

Main Results:

• Overall TTI rate was 5.3% in the cohort, rising to ~20% for children with OM.
• TTI rates showed seasonal variation with a dip in 2020; TTI-A rates were stable.
• Key predictors for TTI included sensorineural hearing loss, chronic adenoiditis, and cleft palate.
• Older age (4-8 years), chronic adenoiditis, and sleep disorders strongly predicted TTI-A.

Conclusions:

• Surgical rates for OM remained largely stable, excluding pandemic-related fluctuations.
• Sensorineural hearing loss is a major risk factor for TTI, while older age is key for TTI-A.
• Identifying high-risk patients can inform surgical decision-making and resource allocation.