Abstract
Limited data exists regarding risk factors for otitis media in older children and specifically those for which surgical intervention is performed. This study investigated potential risk factors in this older age group who required pressure equalization tube (PET) insertion. Retrospective cohort study. Tertiary care pediatric academic medical center. Children 6-12 years old undergoing PET insertion between October 1, 2010 and September 30, 2011. Data was stratified into two separate age cohorts (6-7 versus 8-12-year-olds) and compared using chi-square analysis. A total of 263 patients met study criteria. PET insertion was most common in 6 year-olds (36%, 95/263). Presence of siblings (p=0.03) and history of recurrent upper respiratory tract infection (p<0.01), otalgia (p<0.05), otorrhea (p<0.001), and nasal discharge (p<0.001) were common in the older cohort. No statistical difference was found for history of recurrent acute otitis media, allergy, asthma, or atopy between the two groups (p=0.23-0.92), although the overall prevalence of these conditions was high in both cohorts. The 8-12-year-olds had a history of recurrent upper respiratory tract infection and more infectious symptoms than the 6-7-year-olds. Atopy can lead to a heightened susceptibility to upper respiratory tract infections and potential increase in the relative risk of otitis media. In our patient population, while there was no statistically significant difference in history of asthma, allergy, or atopy, the overall prevalence within both cohorts was relatively high. Therefore, this study provides insight into many pertinent and potentially modifiable risk factors for older children requiring PET insertion.
Highlights
Chronic otitis media (COM) and recurrent otitis media (ROM) are two of the most common infectious diseases worldwide
pressure equalization tube (PET) insertion was most common in 6 year-olds (36%, 95/263)
No statistical difference was found for history of recurrent acute otitis media, allergy, asthma, or atopy between the two groups (p=0.23-0.92), the overall prevalence of these conditions was high in both cohorts
Summary
Chronic otitis media (COM) and recurrent otitis media (ROM) are two of the most common infectious diseases worldwide. COM and ROM affect diverse cultural and racial groups distributed in both developing and industrialized countries. The risks of ROM or COM include suppurative complications, antibiotic resistance, tympanosclerosis, retraction pockets, ossicular chain erosion, cholesteatoma, and conductive hearing loss that might affect language, speech, or psychological development. Tympanostomy tube insertion is the main surgical intervention for otitis media. Each year in the United States, 667,000 children under 15 years old receive tympanostomy tubes, which accounts for more than 20% of all ambulatory surgery in this age group [1]. At an average cost of $2700 per procedure, this contributes approximately $1.8 billion in health care costs and doesn’t include the added financial burden from
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