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Tympanostomy Tube Placement and Auditory Brainstem Response Test Under Sedation
Haroon M Ali1, Rhea M Vidrine2, Cheri D Landers2
1University of Wisconsin-Madison, Madison, WI, USA.
Clinical Pediatrics
|December 26, 2025
Summary
Pediatric auditory brainstem response testing combined with tympanostomy tube placement is feasible outside the operating room under sedation. This approach shows potential for reduced costs and wait times, with a low rate of minor adverse events.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Anesthesiology
- Neuroscience
Background:
- Auditory brainstem response (ABR) testing in children typically requires tympanostomy tubes, usually placed under general anesthesia in the operating room (OR).
- This process necessitates separate procedures, increasing healthcare costs and patient wait times.
Purpose of the Study:
- To evaluate the feasibility and safety of performing tympanostomy tube placement concurrently with ABR testing under sedation outside the OR.
- To assess the efficacy of sedation provided by pediatric critical care medicine and hospitalist physicians for this combined procedure.
Main Methods:
- A retrospective review of 28 pediatric cases undergoing tympanostomy tube placement and ABR testing under sedation (propofol) outside the OR between July 2021 and February 2024.
- Data collected from two children's hospitals in the United States.
Main Results:
- All 28 procedures were successfully completed.
- Six patients (21%) experienced adverse events, with five having minor respiratory issues.
- One patient had laryngospasm requiring intubation and Pediatric Intensive Care Unit admission.
- Compared to OR procedures under general anesthesia, sedation outside the OR demonstrated lower facility costs and reduced wait times.
Conclusions:
- Combining tympanostomy tube placement and auditory brainstem response testing under sedation outside the OR is a feasible and potentially cost-effective approach for pediatric patients.
- Sedation managed by pediatric critical care and hospitalist physicians appears safe for this combined procedure, with a low incidence of significant complications.
