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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
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Tympanocentesis or not? A prospective cohort study for obstructive sleep apnea children in conjunction with

Junji Yao1,2,3,4, Tingting Jin1,2,3, Anying Huang1,2,3

  • 1Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Frontiers in Medicine
|May 28, 2026
PubMed

Insights

For children with obstructive sleep apnea and asymptomatic otitis media with effusion, both watchful waiting and tympanocentesis offer effective management. Tympanocentesis may resolve otitis media with effusion faster, aiding hearing improvement.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Audiology

Background:

  • Obstructive sleep apnea (OSA) and otitis media with effusion (OME) frequently coexist in pediatric patients.
  • Asymptomatic OME in OSA patients presents a management challenge, requiring careful consideration of treatment strategies.

Purpose of the Study:

  • To compare the efficacy of tympanocentesis versus watchful waiting for managing asymptomatic OME in children with OSA.
  • To evaluate the impact of these interventions on hearing outcomes and OME resolution over a 3-year follow-up period.

Main Methods:

  • A prospective cohort study involving 73 pediatric OSA patients with asymptomatic OME.
  • Patients were divided into tympanocentesis (n=35) or observation (n=38) groups based on parental choice, with all undergoing adenoidectomy and tonsillectomy.
  • Outcomes were assessed using audiometric testing, tympanometry, and otoscopy over a 1-year follow-up.

Main Results:

  • The tympanocentesis group showed quicker hearing improvement and OME resolution compared to the observation group.
  • Cox regression analysis indicated no significant difference in the overall time to OME healing between the groups.
  • Both management strategies proved effective over 3 years with low recurrence rates.

Conclusions:

  • Watchful waiting and tympanocentesis are both viable options for pediatric OSA patients with asymptomatic OME.
  • Tympanocentesis may offer a faster resolution of OME and improved hearing, potentially representing a simplified and economical approach.
  • Individualized treatment decisions are crucial for optimizing outcomes in this patient population.

Keywords:
adenoid tonsillectomychildhood obstructive sleep apneachildhood otitis media with effusionobservational studytympanocentesis

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