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Compliance with tympanostomy tube insertion guidelines in Finland

Vesa Lahdes1, Tuomo Puhakka1, Tero Vahlberg2

  • 1Department of Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku University Hospital, Turku, Finland.

Acta Oto-Laryngologica
|May 6, 2025
PubMed

Insights

Many pediatric tympanostomy tube insertions (TTI) in Finland do not meet national guidelines. This highlights a need for better education and potential guideline revision to align with international standards.

Area of Science:

  • Pediatric Otolaryngology
  • Surgical Appropriateness
  • Evidence-Based Medicine

Background:

  • Tympanostomy tube insertion (TTI) is the most common surgical procedure in pediatric otorhinolaryngology.
  • Assessing TTI appropriateness is crucial for optimizing pediatric surgical care.

Purpose of the Study:

  • To evaluate the adherence of TTI procedures to Finnish national recommendations.
  • To assess long-term ear-related quality of life in cases where surgical criteria were not met.

Main Methods:

  • Retrospective review of 355 TTI procedures in children under 10 years old at Turku University Hospital, Finland (2019).
  • Analysis of factors influencing surgical decisions.
  • Administration of the Otitis Media 6 questionnaire to assess ear-related quality of life in 2021.

Main Results:

  • Only 33% of TTIs met criteria for recurrent acute otitis media, and 23% for chronic otitis media with effusion.
  • A significant 44% of procedures did not meet either national criterion.
  • Ear-related quality of life was consistently high across all patient groups, irrespective of criterion fulfillment.

Conclusions:

  • A substantial proportion of TTIs were performed without meeting national guidelines, indicating a need for enhanced professional education and clinical decision-making evaluation.
  • Discrepancies between Finnish and international guidelines suggest a need to re-evaluate Finnish criteria for better alignment with global standards.
Abstract

Keywords:
Tympanostomy tube insertionguidelineotitis mediaquality of life

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