Impact of Tympanostomy Tubes on Pediatric Otoacoustic Emission Testing

Evaluate the impact of patent tympanostomy tubes (TT) on otoacoustic emissions (OAE) in patients with normal pure tone audiometry (PTA).

Retrospective review of patients who underwent TT placement with paired postoperative audiogram and OAEs at 1, 2, 4, and 8 kHz were included. Frequencies with PTA >20 dB or nonpatent TTs were excluded. OAEs were graded by signal-to-noise ratio and distortion product as "present," "reduced," or "absent."

In total, 124 patients (217 ears) were included with a mean age (SD) of 3.9 (3.2) years and OAE testing occurring 4.5 (4.7) months postoperatively. OAE absence rates were 85% at 1 kHz (n = 165), 57% at 2 kHz (n = 203), 56% at 4 kHz (n = 206), and 83% at 8 kHz (n = 135).

Absent OAEs were the most common result at all frequencies, especially 1 and 8 kHz. Overall, 78.8% of patients failed at least one tested frequency, despite normal PTA and patent TTs, suggesting a potential direct impact of TTs on OAE outcomes. Clinicians may need to exercise caution when interpreting OAEs in patients with patent TTs, and further research may warrant a reevaluation of OAE utility in this context.