Complication Of Insertion Research Articles (Page 1)

Background: Cerebral edema after resuscitation from cardiac arrest (CA) may elevate intracranial pressure (ICP) and lower brain tissue oxygen (PbtO2) levels, causing secondary brain injury. We initiated a clinical protocol for invasive ICP and PbtO 2 monitoring and management in selected CA patients. Research Question: What specific radiographic and clinical criterial can be used to select post-resuscitation patients for invasive ICP and PbtO 2 monitoring, and does medical therapy mitigate high ICP (>22mmHg) and low brain oxygen (<20mHgHgHH)? Aim: Characterize the initial experience of selected post-CA patients with early radiographic edema managed with ICP/PbtO 2 monitoring. Approach: Right frontal Raumedic PTO catheters were placed in patients with abnormal head CT (loss of gray-white differentiation, narrowed cisternal spaces at the tentorium, diffuse loss of sulci), and early EEG suppression ratio >70%. We excluded patients radiographically herniated, lacking cranial nerve reflexes, requiring systemic anticoagulation, or not desiring aggressive care. Monitors were placed during TTM, prior to rewarming, and elevated ICP and low PbtO 2 managed with a clinical algorithm. Results: Ten monitored patients included 6 women and 4 nonwhite people of mean age 40 (±13) years; 8/10 had noncardiac etiology of arrest. The ICP was elevated in 10/10 patients, requiring treatment with head positioning, sedation, cerebral perfusion pressure optimization, temperature management, osmotherapy, mild hyperventilation, and barbiturates. PbtO 2 was <20mmHg in 8/8 patients, requiring treatment with increased FiO 2 or PEEP, fluids, vasopressors, inotropes, prone positioning, and ventilator changes. Of 10 patients with elevated ICP, 2 progressed to brain herniation, 2 rearrested and died, 6 were “successfully” managed with nonsurgical therapies, and 2 (20%) survived and made a good functional recovery. Prognostic MR imaging was often delayed due to monitoring, and temperature management often prolonged due to ICP elevation. No complications of ICP monitor insertion or maintenance were noted. Conclusions: All qualifying patients had dangerous elevations of ICP and low PbtO 2 . These abnormalities often responded to non-surgical therapy, and in 2/10 cases resulted in good functional outcomes. Intracranial hypertension and brain hypoxia after cardiac arrest are treatable, and might reduce secondary neurological injury leading to better outcomes.

Abstract Objectives: This study aimed to analyze the incidence, types, and risk factors associated with central venous catheter (CVC) insertion complications in a tertiary care center in India. It sought to evaluate the impact of insertion techniques (ultrasound-guided vs. landmark) and anatomical sites on complication rates, while addressing barriers to ultrasound adoption in the Indian healthcare context. Methodology: A retrospective cohort study was conducted at a single center in Punjab, analyzing 1264 CVC insertions performed between July 2021 and December 2023. Data were extracted from electronic and paper medical records, including patient demographics, insertion site (subclavian, internal jugular [IJV], and femoral), technique (ultrasound-guided or landmark), catheter type, and complications (early: Arterial puncture, pneumothorax; delayed: Infection, thrombosis). Statistical analyses included descriptive statistics, Chi-square tests, and ANOVA to compare outcomes. Results: The overall complication rate was 8.15% (early: 5.62%, delayed: 2.53%). Subclavian insertions were most common (71.7%), followed by femoral (16.2%) and IJV (12.1%). Ultrasound guidance was used in only 9.3% of cases but demonstrated zero early complications in subclavian insertions (P = 0.01). Femoral catheters had the highest thrombosis rate (2.9%) and shortest dwell time (median 3 days). Infection rates (1.36 per 1000 catheter days) showed no correlation with dwell time (P = 0.612). The landmark technique predominated (90.7%), with low pneumothorax rates (0.2%) despite high subclavian use. Conclusion: This study highlights the safety benefits of ultrasound guidance, particularly for subclavian CVCs, and underscores the need for policy reforms to overcome barriers to its adoption in India. Femoral catheters, despite shorter dwell times, posed higher thrombosis risks, suggesting careful site selection is critical. Standardized protocols and targeted training could further reduce complications in resource-limited settings.

Chest tubes are a standard procedure. Despite it being a regular intervention, complication rates can be up to 30%, impacting patient's health, morbidity, and mortality. Checklists have been shown to reduce complications for other medical procedures. Data on implementing a checklist are increasing, while data on the development are still low. A guide on analysing and designing a chest tube accordingly has not yet been published. Therefore, the aim of the study is to introduce a structured design of a chest tube checklist based on analyses using human factor analysis tools. A multifactor analysis was performed focusing on chest tube insertion and possible complications using hierarchical task analysis, a failure mode and effective analysis (FMEA), and a bow-tie analysis. The data were collected through a workshop in addition to published literature on chest tube complications. The FMEA revealed events with a high level of risk priority numbers (RPNs). In total, 247 RPNs were calculated. Failure modes adding up to 147 RPNs were summarized as 'malposition of chest tube'. 'Lack of sterility' accounted for 100 RPNs. The FMEA revealed the importance of indication, preparation, and equipment in assessing risk and ultimate failure. 'Malpositioning of chest tube' was used for the bow-tie analysis. Contributing factors were extracted from the FMEA, preventative controls, recovery barriers and consequences analysed the lack of sterility was addressed by 'preventative controls', recovery barriers and consequences in preparation, equipment, and chest tube insertion. Based on these findings, a checklist was designed. Human factor analysis tools can be used to analyse procedure's complications and its causes. Future data will need to show the effectiveness of the checklist.

Multicenter Analysis of Long-Term Outcomes of Artificial Urinary Sphincter Surgery Following Urethroplasty.

Exsanguinating haemorrhagic shock due to major trauma is associated with high mortality. Rapid intravenous volume replacement with blood products is a crucial element of early treatment. When peripheral intravenous access cannot be obtained, pre-hospital placement of a large-calibre central venous catheter, known as a trauma line, can be a life-saving alternative. This was a retrospective cohort study to evaluate the feasibility, efficacy and safety profile of inserting a 14-Fr trauma line in patients with exsanguinating haemorrhage due to major trauma in the pre-hospital setting. Success rates, outcomes and complications of trauma line insertion were determined by cross-referencing pre-hospital patient care records with emergency department notes, operating notes and post-mortem findings. Between 1 January 2019 and 31 July 2023, London's Air Ambulance attended 8104 patients. Trauma line insertion was attempted in 346 (4%) patients with success in 276 (80%). Successful trauma line insertion was associated with significantly greater transfusion of pre-hospital blood products compared with those in whom insertion was unsuccessful (median (IQR [range]) 4 (2-6 [0-12]) vs. 2 (0-4 [0-8]) units, respectively; p < 0.001). Survival to presentation to the emergency department was higher after successful trauma line insertion (149/279 (54%) vs. 25/70 (36%); p = 0.006). There were 184 (53%) patients transported to hospital. Complications in this group were reported in 8 (4%) patients: malpositioned trauma line (n = 3); vascular injuries (n = 2); iatrogenic pneumothorax (n = 2); and positive trauma line tip culture (n = 1). In patients with exsanguinating haemorrhage who are in severe shock or traumatic cardiac arrest, pre-hospital trauma line insertion is feasible and associated with an acceptable risk of procedural complications. Trauma lines enable the delivery of a greater volume of blood products in the pre-hospital setting, which may be associated with increased pre-hospital survival.

Introduction: A JJ stent placed before retrograde intrarenal surgery (RIRS) may passively dilate the ureter and facilitate ureteral access sheath (UAS) implantation. No studies have examined the significance of preoperative JJ stent diameter, even though numerous studies have shown that UAS insertion is simpler in patients with them. Our study examines the relationship between preoperative ureteral stent caliber and UAS placement and RIRS results. Materials and Methods: A total of 655 patients with known preoperative double-J stent size before RIRS were analyzed. The patients were categorized into two groups based on their preoperative stent diameter (Group 1: 4.8 Fr and Group 2: 6 Fr). Demographic and clinical data of the patients, stone characteristics, surgical data, perioperative and postoperative complications, duration of hospitalization, and stone-free rates (SFRs) were analyzed for comparison. Results: The groups contained 323 and 332 patients. The demographic data of the two groups were similar. There was no statistically significant difference between SFR, UAS insertion rate, hospitalization time, and complications. The success rate of placing a UAS with a higher caliber was statistically significantly higher in those with a 6 Fr JJ stent than in those with a 4.8 Fr stent (P = .001). The operation time was also shorter in the group with a thicker stent (P = .003). Conclusions: Our data suggest that while the preoperative JJ stent diameter does not significantly affect overall UAS insertion success, complication rates, or postoperative stone-free status, using a 6 Fr stent facilitates the placement of larger UAS calibers and may decrease operation time. Consequently, although both stent diameters are efficacious, selecting a 6 Fr stent may provide procedural benefits without jeopardizing safety or results.

Comparison of tympanostomy tube insertion with and without radiofrequency ablation eustachian tuboplasty for treating chronic otitis media with effusion.

BackgroundThe aetiology of syncope can be challenging to undermine because of its sporadic nature. Implantable loop recorders (ILRs) are recommended to be used early in undetermined syncope to establish a symptom-rhythm correlation if cardiac syncope is suspected. The real-world diagnostic yield of ILRs is not well established.PurposeThis study aimed to evaluate the diagnostic yield of ILR devices in patients with undetermined syncope.MethodsThis single-centre, retrospective study reviewed the electronic medical records of all patients who underwent ILR insertion for syncope from January 2017 to June 2022. Abnormal rhythm strips on ILRs were reviewed by a cardiac physiologist and cardiology consultant to determine their significance. The primary outcome was the total number of cardiac implantable electronic devices (CIEDs) inserted due to ILR findings. Secondary outcomes included (1) a comparison of baseline characteristics between the group of patients who had an arrhythmia detected on ILRs and patients who had no detected arrhythmia and (2) the total number of clinically significant events (CSEs), defined as symptomatic arrhythmia, asymptomatic arrhythmia deemed clinically related to the patients' history of syncope, and the absence of arrhythmia when the patient experienced syncope. Complications of ILR insertion were recorded. Given that normality was not assumed, a non-parametric analysis was utilized to compare baseline characteristics.ResultsA total of 215 patients were included in this study, of which 43 (20%) had a CIED inserted due to ILR findings. Baseline characteristics were similar between the group of patients who had an arrhythmia detected on ILRs and patients who had no detected arrhythmia, except for age. One hundred three (47.9%) of the patients had CSEs. Symptomatic arrhythmias were the most common CSEs, out of which a sinus pause of greater than six seconds was the most prevalent arrhythmia. There were no complications that required early explant of the ILR in this cohort.ConclusionILRs detected a clinically significant arrhythmia and the absence of an arrhythmia in 92 (42.7%) and 11 (5.1%) patients with undetermined syncope, respectively. ILR is a valuable diagnostic tool in this cohort of patients. Further studies looking at its cost-effectiveness would be beneficial.

Bedside Ultrasound-Guided Innominate Vein Cannulation for Central Line Placement in Newborns.

BACKGROUNDCentral venous access is essential for administering chemotherapy in patients with gastrointestinal cancer. Peripherally inserted central catheters (PICC) and totally implantable venous access ports (TIVAP) are widely used, but comparative data regarding their impact on catheter-related complications and quality of life (QoL) remain limited.AIMTo evaluate the impact of TIVAPs compared with PICC on catheter-related complications and QoL in patients with gastrointestinal cancer undergoing chemotherapy.METHODSThis retrospective study included adults with gastrointestinal cancer who underwent central venous access device insertion for chemotherapy at our institution between December 2021 and December 2024. Inclusion criteria encompassed indications for intermittent intravenous chemotherapy, anticipated treatment duration of ≥ 12 weeks, an adequate preoperative hematologic profile, accessible upper body veins, and complete medical records. Patients were excluded if they had an anticipated survival of less than three months, active systemic infection, severe thrombosis or coagulopathy, communication barriers, or an urgent need for dialysis access. Patients were assigned to either the PICC or TIVAP group based on device type. Data collected included demographic variables, cancer characteristics, insertion procedure details, complications, and QoL, assessed via the EuroQol 5-Dimensions-3 levels, visual analogue scale, and the European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30.RESULTSA total of 346 patients were analyzed. Baseline demographic, clinical, and cancer characteristics were similar between groups. The TIVAP group demonstrated a significantly lower incidence of catheter-related complications than the PICC group, with no pneumothorax occurring in either group. QoL assessments at baseline were comparable. At one month, the TIVAP group exhibited significantly higher EuroQoL Five Dimensions health state scores and QLQ-C30 global health status scores. Multivariate analysis identified TIVAP use, catheter tip placement in the distal superior vena cava/right atrium, prophylactic antibiotic administration, and antimicrobial dressing application as independent protective factors associated with reduced complications and improved QoL.CONCLUSIONIn patients with gastrointestinal cancer undergoing chemotherapy, TIVAPs are associated with a lower incidence of catheter-related complications and improved QoL than PICCs. Optimal device selection, precise catheter tip positioning, and effective perioperative management are critical for minimizing complications and enhancing patient-reported outcomes during treatment.

ObjectiveCatheter-related thrombosis is a common complication of central venous catheter insertion. As the use of central venous catheters increases in pediatric critical care settings, catheter-related thrombosis is becoming more common among patients who typically have multiple risk factors for thromboembolism. We aimed to investigate impact of catheter-to-vein diameter ratio on thrombosis in pediatric central venous catheterization.MethodsSingle-center, prospective study. In our study, thrombosis risk factors and patient-related factors were excluded.ResultsA total of 50 patients were included in our study. Thrombosis was observed in 34% of the patients. When comparing thrombotic and nonthrombotic patients, factors such as a low aPTT value, dialysis catheter use, certain mutations that may cause thrombosis, a high catheter-to-blood vessel diameter ratio (C/VR), and a high catheter area-to-blood vessel area ratio (C/VA) are associated with an increased risk of thrombosis. In backwards logistic regression analysis of thrombosis risk, older age, a decreased catheter area, a high C/VA ratio, and the use of dialysis catheters contributed to an increased risk of thrombosis. Patients with dialysis catheters have a 64.9 times greater risk of thrombosis than do those with central venous catheters. The C/VR, with a cut-off value of 0.197, and the C/VA, with a cut-off value of 0.088, are effective indicators in ROC analysis for thrombosis.ConclusionIn conclusion, selecting a catheter with a diameter-to-vessel diameter ratio of less than 1:5 in normovolaemic paediatric patients should be considered as a strategy to reduce the risk of catheter-related thrombosis.

Aim To retrospectively compare port catheter-related complications in chemotherapy patients with and without bevacizumab treatment, and to identify additional factors contributing to these complications. Methods This retrospective study included cases who received chemotherapy with a port catheter between January 2014 and May 2018 at our hospital. The study retrospectively collected data on patient demographics, malignancy details, comorbidities, chemotherapy drugs, catheter insertion timing, complications, removal reasons, neutropenia, culture results, and patient outcomes. Patients were grouped based receiving or not receiving bevacizumab in combination with chemotherapy. Results The study included 600 patients, 227 of whom received chemotherapy combined with bevacizumab. The results showed that leukemia was significantly associated with an increased risk of catheter complications (p &lt; 0.001), while the presence of any comorbidity was independently linked to a decreased risk of complications (p = 0.030). In patients receiving bevacizumab, complications occurred more frequently when the catheter was placed simultaneously with the drug (p = 0.017). Additionally, the complication group had a significantly shorter catheter duration (p &lt; 0.001) and a higher mortality rate (p = 0.037). Multivariable logistic regression analysis revealed that leukemia was a significant independent factor for increased complication risk (p &lt; 0.001), while comorbidities were protective against complications (p = 0.030). Conclusion Bevacizumab was associated with increased complication risk in only subjects in which treatment was initiated immediately after catheter placement. However, multivariable analysis revealed that this significant relationship disappeared when adjusted for other factors, leaving leukemia as the only risk factor independently associated with port catheter complications.

To initiate less invasive surfactant administration (LISA) in authors' unit using a quality improvement (QI) approach and increase LISA rates by 50% over 10 mo period. The authors adopted a QI methodology to address this issue. The proportion of surfactant administration done by the LISA method was the primary outcome indicator. Focused group discussions were conducted with doctors and nurses during the initial phase to identify the root causes. Meetings were conducted where team members were given descriptions of the insertion method, complications and precautions to be taken. All the members were trained to use LISA on mannequins in a simulation lab. They were also trained regarding the fixation of continuous positive airway pressure (CPAP), monitoring of complications and correction steps. Multiple Plan-Do-Study-Act (PDSA) cycles were implemented. A standard operating policy was developed, and all babies requiring surfactant were administered surfactant with the LISA technique. Over the 10 mo, the proportion of neonates who received surfactant via the LISA method increased from 0 to 90%. Complications such as desaturation (74%), surfactant reflux (32.1%), bradycardia (25%), and unilateral administration of surfactant (26.7%), which were initially observed, gradually decreased to 7.4%, 3.7%, 7.4%, and 7.4%, respectively. Utilising QI tools, the authors achieved an increase in the rate of surfactant administration by the LISA method by more than 50%.

Objective:This study aimed to analyze the efficacy and safety of peripherally inserted central catheters (PICCs) inserted by the PICC nursing team in the neuro intensive care unit (ICU).Methods:A retrospective analysis was conducted on 756 patients admitted to the neuro ICU of a clinical neurosciences center in Shanghai, China, between January 2019 and December 2022. All patients required elective central venous access and had a PICC inserted by the PICC nursing team. Data on patient demographics, catheter type, insertion approach, puncture site, tip position, insertion success rate, and complications were extracted from electronic medical records using Questionnaire Star software. The study compared outcomes before and after the implementation of a specialized training program for the PICC nursing team, which included theoretical and practical training on PICC insertion techniques, maintenance, and complications management.Results:Following the implementation of the trained PICC nursing team, significant changes were observed in catheter type and insertion technique. The use of 3-way valve Solo catheters and power-injectable open-ended catheters increased, while the use of 3-way valve catheters decreased. In addition, the use of ultrasound-guided modified Seldinger technique (MST) increased significantly, with a corresponding decrease in conventional PICC insertion and MST without ultrasound guidance. Malpositioned tips occurred in 6.3% of cases. Notably, after the implementation of the trained team, complications significantly decreased (P<0.05) and the first-attempt success rate significantly increased (P<0.05) compared with the period before the training program.Conclusions:In neuro ICU patients, the use of PICCs inserted by a well-trained, competent PICC nursing team demonstrated improved outcomes, including reduced complications, increased first-attempt success rates, and higher quality of care. These findings highlight the importance of specialized training for PICC nursing teams in neurointensive care management.

A significant complication of dialysis catheter insertion: left brachiocephalic vein rupture: A rare case report

Background: Central venous access is a procedure commonly done in the management of critically ill patients. Central venous catheters (CVCs) are used for infusion of intravenous medications and fluids, parenteral nutrition and for the measurement of hemodynamic variables. Despite the utility of CVCs, placement of these lines is not without inadvertent risks, which could be serious and life threatening. The complications vary with the type of access and can present immediately or in a delayed manner. Methods: This prospective, observational study was conducted on patients admitted under the Department of Surgery at Christian Medical College and Hospital, Ludhiana, from November 1, 2017, till April 31, 2019. Results: The incidence of catheter-related bloodstream infection was more in the internal jugular vein (IJV) cannulation 7.62% than the subclavian vein (SCV) cannulation 6.67%. The incidence of infection of CVC was more when the catheter was in situ for more than 14 days (15.00%) compared to when it was placed for 7–14 days (11.36%) and least when the line was placed for 7 days (3.57%). The incidence of thrombosis was found to be more in the IJV cannulation 2.86% compared to the SCV 2.22%. Conclusion: This study concluded that the catheter left in situ for more than 7 days had a higher incidence of infectious complications. Delayed complications were noted more with IJV route of cannulation compared to the SCV. Proper aseptic conditions should be followed to prevent central line infection.

BACKGROUND Ventriculoperitoneal shunt (VPS) catheter insertion is one of the most widely accepted surgical procedures for hydrocephalus. Migration of the end of the distal VPS catheter into the scrotum is one of the rare complications of VPS catheter insertion. AIM To review the demographics, clinical characteristics, and outcomes of the surgical procedures provided for the cases of migration of the distal VPS catheter into the scrotum. METHODS This is a systematic review of the published cases, and the literature search was performed from 1974 to June 30, 2024, to retrieve the relevant manuscripts. The cases were grouped into two. Group A included cases of migration of the distal VPS catheter into the scrotum, detected in children. Group B included the cases of migration of the distal VPS catheter into the scrotum, which was detected in adults and older people. RESULTS One hundred-twenty cases of migration of the distal end of VPS catheter into the scrotum were included in this study, a systematic literature review. Group A included n = 112 cases, and group B included n = 8 cases only. Three-fourths of the cases involved the right scrotum. Bilateral involvement was rare. The indication for initial VPS insertion was congenital hydrocephalus in four-fifths of the group A cases. The majority were infants at the time of initial shunt insertion. Four-fifths of the group A cases were 24 months-old or younger at the time of clinical diagnosis and treatment was provided for migration of the distal VPS catheter into the scrotum. In children, the interval from VPS insertion or shunt revision if any, to the diagnosis of the complication mentioned above was 12 months or less in four-fifths of the cases. The repositioning of migrated distal VPS catheter into the peritoneal cavity and herniotomy was preferred for the surgical procedure, and it was performed for two-thirds of group A cases. CONCLUSION Migration of the distal part of the VPS catheter into the scrotum is a rare complication of cerebrospinal fluid diversion via VPS catheter insertion. It was most frequent in children, and the right side of the scrotum was most often involved.

Background: Effective airway management remains a cornerstone of emergency and surgical care, especially in patients with anticipated or unanticipated difficult airways. The choice of device can significantly impact patient outcomes. Among the available options, the endotracheal tube (ETT) and laryngeal mask airway (LMA) are widely used. However, the clinical superiority of one over the other in difficult airway scenarios continues to be a topic of ongoing investigation, particularly in resource-constrained or emergency settings. Objective: To compare the effectiveness of ETT and LMA in managing difficult airways in terms of insertion time, success rate, and complication frequency. Methods: A cross-sectional study was conducted over six months across three tertiary hospitals, enrolling 130 adult patients aged 18 years and above who required general anesthesia and met the criteria for difficult intubation. Patients were allocated to receive either an ETT or LMA based on the attending anesthesiologist’s clinical judgment. Insertion time was recorded in seconds, and any complications such as sore throat, airway trauma, or laryngospasm were documented. Data were analyzed using IBM SPSS Version 29. An independent t-test and chi-square test were applied to determine statistical significance, with p &lt; 0.05 considered significant. Results: The mean insertion time for LMA was significantly shorter at 54.3 seconds compared to 183.6 seconds for ETT (p &lt; 0.001). The first-attempt success rate was higher for LMA (84.6%) than ETT (30.8%) (p &lt; 0.001). Complications were notably fewer with LMA (23.1%) than with ETT (53.8%) (p = 0.002), suggesting improved safety and ease of use with LMA in difficult airway cases. Conclusion: LMA proved to be a faster, safer, and more effective option compared to ETT in the management of difficult airways, especially in scenarios demanding rapid airway control. Further large-scale studies are recommended for broader validation.

Background: Central venous catheterization (CVC) is a frequently performed procedure in anesthesia and critical care settings. Modern procedures have improved significantly, particularly with increasingly sophisticated venous verification methods and ultrasound guidance. While the associated historical complication rates reflect this improvement, complications such as inadvertent arterial puncture, arterial cannulation, pneumothorax, deep vein thrombosis, and catheter-associated infection are still significant risks. Methods: This narrative review was constructed from a literature review using a search strategy of the MESH terms central venous access, central venous line, complications, insertion, and puncture, published between 2015 and 2025. Inclusion criteria included peer-reviewed full-text articles. Supplementary articles were included to construct the historical perspectives on central venous access and complications. Results: Our review offers a simple management algorithm for the mechanical complications of CVC insertion. This algorithm focuses on inadvertent arterial puncture/cannulation, with steps ranging from external compression to endovascular repair or surgical intervention. Conclusions: Moving forward, clinicians are encouraged to look into the future to predict what complications may arise as our modern patient cohort evolves. When complications develop, clinicians should know how to manage them to prevent further patient morbidity.

To describe the current tympanostomy tube insertion (TTI) complication rates occurring within 3 years of surgery in the post-intervention era. Current TTI complication rates in children are based on reports from a meta-analysis that was published in 2001, reporting on 16 to 26% otorrhea rates, cholesteatoma development of 0.7%, and tympanic membrane perforation (TMP) of 2.2 to 16%. Since then, interventions aimed at reducing pediatric otitis media burden have been largely implemented worldwide, and indications for TTI have been published. Population-based longitudinal study. Data were anonymously retrieved from a big stable healthcare database between 2005 and 2021. Hospitals and ambulatory surgical centers, nationwide. Children who underwent TTI and completed 3 postoperative follow-up years within the health insurance. We excluded children with previous otological surgery and congenital craniofacial anomalies. Children were categorized into the younger (0-<7 yr) and older (7-18 yr) age groups. TTI (therapeutic). Number of TTI performed per 100,000 children per study year, and cumulative incidence of these postoperative complications: TT removal, otorrhea, TMP, cholesteatoma development, and need for mastoidectomy. Of the 19,920 unique children identified, 86.6% were in the younger age group with a mean age of 3.57 ± 1.59 years, and 61% were boys. At the end of follow-up, older children had statistically significantly higher TMP (6.9% versus 3.3%, p < 0.001), TT removal (5.1% versus 3.8%, p < 0.001), cholesteatoma (2.2% versus 0.8%, p < 0.001), and mastoidectomy (0.8% versus 0.3%, p < 0.001) rates when compared with younger children, respectively. Younger children experienced higher otorrhea rates when compared with older children (11% versus 6.4%, p < 0.001) but for a shorter period (324 ± 290 versus 404 ± 303 days, p < 0.001). Post-TTI complication rates are lower in the post-intervention era, except for cholesteatoma. This current quantitative appreciation of TTI complications can help both patients and caregivers define realistic postoperative expectations.