Examining Tympanostomy Tube Outcomes in Indigenous vs. Non-Indigenous Children of Northern Quebec

Chronic otitis media with effusion (COME) and recurrent acute otitis media (rAOM) pose significant burdens on pediatric patients and their families. These conditions disproportionately affect marginalized populations, such as Indigenous communities in Canada, where higher incidence rates and reduced access to care are well documented. This study aims to better understand the sequelae of rAOM/COME following tympanostomy tube (TT) insertion in Indigenous pediatric patients living in northern Quebec.

A retrospective matched cohort study was conducted on children who underwent TT insertion. Indigenous patients were matched 1:2 by age and gender with non-Indigenous controls. Data collected included comorbidities, TT indications, surgical history, cancellation rates, otolaryngology and audiology assessments (pre- and post-operative), operative notes, and follow-up documentation.

A total of 240 patients (80 Indigenous and 160 non-Indigenous) were analyzed. Baseline characteristics, surgical wait times (p = 0.18), and time to first follow-up (p = 0.33) were similar. At first follow-up (mean 5.4-5.9 months), Indigenous children were more likely to have tympanic membrane perforation (6.2 % vs. 1.3 %, p = 0.04). Tube extrusion was observed in 23.8 % of Indigenous children versus 15 % of non-Indigenous children (p = 0.054). Among Indigenous patients, Inuit children had a significantly higher extrusion rate (50 %) compared to First Nations children (23.3 %) (p = 0.04).

While access to care appears equitable post-referral, Indigenous children-particularly Inuit-exhibit higher rates of tympanic membrane perforation and possible early tube extrusion. These differences underscore the need for tailored approaches and further investigation into population-specific pathophysiology.