Factors Related to Tympanic Membrane Perforation in Children with Acute Suppurative Otitis Media

Abstract

Objective To explore the factors related to tympanic membrane perforation in children with acute suppurative otitis media,and to provide reference for clinical practice. Methods We reviewed the clinical data of 1274 children with acute suppurative otitis media from February 2017 to May 2020,and analyzed the factors related to tympanic membrane perforation. Results Tympanic membrane perforation occurred in 67 out of the 1274 children with acute suppurative otitis media,with the incidence of 5.27%.The univariate analysis showed that 11 factors including the duration of onset(t=2.381,P=0.017),upper respiratory tract infection(χ2=12.228,P=0.000),pulmonary infection(χ2=5.242, P=0.022),chronic sinusitis(χ2=12.715,P=0.000),adenoid hypertrophy(χ2=4.783,P=0.029),tympanic empyema(χ2=16.020,P=0.000),the duration of using antibiotics(t=-2.277,P=0.025),combined use of antibiotics(χ2=5.587,P=0.018),the time from onset to selection of antibiotics according to drug sensitivity(t=3.716,P=0.000),procalcitonin(t=2.599,P=0.009),and white blood cell count in peripheral blood(t=2.196,P=0.031)were related to tympanic membrane perforation in children with acute suppurative otitis media.The multivariate logistic analysis showed that the duration of onset(OR=4.854,95% CI=2.675-8.806,P=0.000),upper respiratory tract infection(OR=6.506,95% CI=3.213-13.171,P=0.000),chronic sinusitis(OR=7.866,95% CI=3.780-16.370,P=0.000),tympanic empyema(OR=2.625,95% CI=1.442-4.777,P=0.002),and time from onset to selection of antibiotics according to drug sensitivity(OR=5.107,95% CI=2.129-12.248,P=0.000)were independent risk factors for tympanic membrane perforation in children with acute suppurative otitis media. Conclusion The incidence of tympanic membrane perforation in children with acute suppurative otitis media can be reduced by early treatment,keeping the Eustachian tube unobstructed,draining the tympanic cavity,preventing chronic sinusitis and upper respiratory tract infection,early drug sensitivity test,and selection of antibiotics based on the test results.