Chronic Otitis Media With Effusion Sequelae in Children Treated With Tubes

University of Minnesota Otitis Media Research Center, University of Minnesota School of Medicine, USA.
Archives of Otolaryngology - Head and Neck Surgery (Impact Factor: 2.33). 06/2003; 129(5):517-22. DOI: 10.1001/archotol.129.5.517
Source: PubMed


To determine incidence and prevalence of middle ear sequelae and abnormal tympanometry results among children with chronic otitis media with effusion (OME) who received standard treatment with tympanostomy tubes.
Prospective cohort study.
Community clinic and academic medical center. Patients A total of 140 children followed up for 8 years after tube treatment.
Tympanic membrane perforation, atrophy, retraction, hearing loss, myringosclerosis, low static admittance (SA) and broad-peaked tympanogram, high SA and narrow-peaked tympanogram, and negative tympanometric peak pressure.
Annual incidence of sequelae was typically greater during 3 to 5 years than 6 to 8 years of follow-up. Greatest increases in incidence during the 5-year follow-up were for atrophy (67%), high SA and narrow-peaked tympanogram (70%), and retraction pocket (47%). Prevalence of these sequelae also increased over time, whereas low SA and broad-peaked tympanogram and negative tympanometric peak pressure decreased during follow-up. Sequela tended to become bilateral over time, and concordance of different sequelae in the same ear was low (kappa, 0.05-0.42).
Annual incidence of sequelae decreased during follow-up. This finding parallels decreasing incidence of OME and tube placement as children mature and demonstrates that sequelae are more likely to develop during active acute and chronic OME. The cumulative effect of incidence resulted in few ears free of sequelae by 8 years of follow-up. Based on this cohort of healthy children with OME, although the risk of sequelae decreased over time, functional and morphologic sequelae were prevalent and may put children at risk for continuing middle ear problems as they grow into adolescence and adulthood.

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    • "In contrast, Valtonen and colleagues reported a point-prevalence of 16.7% for tympanic membrane retraction in their 5-year follow-up study (21). Daly and colleagues found atelectasis in 38% of ears with tubes (22). Only 0.6% of ears that were operated on developed this complication in our study. "
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    ABSTRACT: To study the long-term complications of tympanostomy tube insertion in young children 10 years after surgery. In September 2011, the medical records of all patients who had undergone myringotomy with tympanostomy tube insertion between February 2000 and March 2001 at the two general hospitals of Isfahan University of Medical Sciences were studied. Of the 98 patients who fulfilled the inclusion criteria, 82 patients agreed to participate and were enrolled in the study. The complications of the operation were evaluated in these patients. Of the 164 ears that were operated on, myringosclerosis was found in 17.1%, atrophy of the tympanic membrane in 1.2%, permanent perforation of the tympanic membrane in 0.6% and tympanic membrane atelectasis in 0.6%. None of the patients developed cholesteatoma as a complication of tympanostomy tube insertion. Considering the low risk of serious complications after 10 years, tympanostomy tube insertion is a safe and effective treatment option in the treatment of otitis media with effusion.
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    ABSTRACT: Tympanostomy tube (TT) insertion is one of the most frequently performed procedures in otolaryngology. Otorrhea, tympanosclerosis, retraction, perforation, and cholesteatoma are complications reported in the literature after its application. To determine the incidence and the type of TT insertion sequelae/complications in children presenting with recurrent otitis media and chronic otitis media with effusion undergoing myringotomy and tube placement. Prospective cohort study. A total of 75 children (150 ears) aged 11 months to 10 years were regularly followed up for up to 38 months after TT insertion. Incidence of sequelae/complications: otorrhea--47.3% of the ears; perforation--2.1%; retractions--39.7%; tympanosclerosis--23.3%. Average length of stay: 12.13 months. Mean age at initial tube placement of children not requiring a second set of tubes = 35.9 months and mean age at initial tube insertion of children requiring an additional set of tubes = 25.6 months (P = 0.04). TT stayed longer in the ears that had more episodes of otorrhea (P = 0.01). TT insertion with adenoidectomy was associated with a smaller number of otorrhea episodes (P = 0.02) Otorrhea was the most frequently found complication. TT placement with adenoidectomy was associated with fewer otorrhea episodes. TT extruded later in those ears that had more episodes of otorrhea. Younger age at the time of the initial tube placement is associated with higher incidence of additional tube placement. One in six patients will probably require a second set of ventilation tubes.
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