Evaluation of factors affecting outcome of surgery for otitis media with effusion in clinical practice

Tympanostomy tube sequelae in children with otitis media with effusion: a three-year follow-up study

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.

AIM

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.

STUDY DESIGN

Prospective cohort study.

MATERIAL AND METHOD

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.

RESULTS

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)

CONCLUSIONS

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.