Recurrent tube insertion for chronic otitis media with effusion in children over 6 years

Abstract

Objective: The purpose of this study is to identify the clinical characteristics of children above 6 years of age with chronic otitis media with effusion (COME) who have required pressure equalizing tube (PET) insertions.

Methods: A retrospective chart review was performed of all children above the age of 6 years, who underwent PET insertion due to chronic OME, between 2000 and 2009 at a tertiary care institution. Children were also divided into those with a single PET and those with ≥ 2 PET. Comparison of various characteristics between the two groups was undertaken.

Results: 290 children were identified as having at least one PET insertion after the age of 6 years. 45.5% of the children underwent a single PET insertion while 54.5% underwent 2 procedures or more. No significant gender-based difference was observed. In those patients requiring ≥ 2 PET, 65.2% also underwent tonsillectomy and/or adenoidectomy compared to only 53.8% of children with a single PET intervention (p<0.05). Asthma, trisomy 21 and cleft palate, were more common in those children who had undergone ≥ 2 PET (p<0.001, p<0.01 and p<0.05, respectively).

Conclusions: Children above 6 years of age who have undergone ≥ 2 PET insertions for COME demonstrated an increased rate of tonsillectomy and adenoidectomy. Trisomy 21, cleft palate and particularly, asthma, were also found to be risk factors for COME necessitating ≥ 2 PET insertions.