Risk Factors for Refractory and Delayed De Novo Otitis Media Requiring Pressure Equalization Tube Insertion

Abstract

Objectives: There is substantial information regarding environmental and clinical risk factors for otitis media in young children; however, limited data exist in 6- to 12-year-old patients and specifically those in which surgical intervention is performed. This study investigated potential risk factors for de novo or refractory otitis media in this older age group who required pressure equalization tube (PET) insertion. Methods: A retrospective study was performed at a tertiary care academic hospital for children 6 to 12 years old undergoing PET insertion between October 1, 2010, and September 30, 2011. The data were stratified into 2 separate age cohorts (6-7 versus 8-to 12-year-olds) for analysis. Results: A total of 263 patients met the inclusion criteria. PET insertion was more common in the 6-year-old age group (36%, 95/263), which decreased by age with a negative relationship. No significant sex-based difference was observed. Presence of siblings ( P < .05), otalgia ( P < .05), otorrhea ( P < .001), nasal discharge ( P < .001), and trends of parental smoking ( P = .09) and hearing loss ( P = .06) were identified in the older cohort. No statistical significance was found for history of recurrent acute otitis media (RAOM), allergy, asthma, or atopy between the 2 groups ( P = .22-.97). Conclusions: The older cohort (ages 8-12 years old) had more infectious symptoms including otalgia, otorrhea, and nasal discharge than the younger cohort (ages 6-7 years old). In contrast, history of RAOM, allergy, asthma, and atopy were not significantly different between these age groups. Overall, this study provides further understanding of pertinent risk factors in older children requiring new or recurrent PET insertion.