Tympanostomies with tubes: the parent perspective

Five-year results for use of single-flanged tympanostomy tubes in children

AIMS

To assess the five-year outcome of the use of single-flanged tympanostomy tubes in children, including the time to extrusion, rate of retained tubes and rate of persistent perforation.

MATERIALS AND METHODS

The medical records relating to 640 single-flanged tympanostomy tubes intended for short-term use in paediatric patients were retrospectively reviewed.

RESULTS AND ANALYSIS

We found that 36.4 per cent of the tubes had extruded within 12 months and 71.0 per cent within 24 months. Results showed that 14.1 per cent of the tubes had been removed because of prolonged retention, with a mean time to removal of 38.9 months. The time to extrusion was longer and the rate of retained tubes was higher than those reported for several other short-term tubes. We found that 4.5 per cent of tube insertions had resulted in a persistent perforation, a higher percentage than previously reported for other tubes intended for short-term use. Within five years of tube insertion, 70.5 per cent of the tympanic membranes had normalised.

Is parental perception an accurate predictor of childhood hearing loss? A prospective study

OBJECTIVE

We performed this study to assess whether parental perception of hearing loss predicted the results of audiometric testing in children with recurrent otitis media or persistent otitis media with effusion.

METHODS

As part of a larger prospective observational outcomes study of children undergoing tympanostomy tube placement, the child's parent completed a standardized questionnaire before and after tube placement. In addition, patients underwent age-appropriate audiologic threshold and tympanometry testing before and after tube placement.

RESULTS

We enrolled 113 patients (median age, 2 years), and 93 (82%) completed follow-up. Before treatment, parental perception of hearing loss did not predict hearing threshold level. After tube placement, parental perception of hearing loss was also poorly correlated with change in threshold.

CONCLUSIONS

Parental perception of their child's hearing loss is a poor predictor of objective audiologic findings both before and after treatment with tympanostomy tubes. These findings have important implications concerning the importance of screening for hearing loss in children with otitis media with effusion.