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Eustachian tube function as a predictor of the recurrence of middle ear effusion in children
Author(s) -
Mandel Ellen M.,
Swarts J. Douglas,
Casselbrant Margaretha L.,
Tekely Kathleen K.,
Richert Beverly C.,
Seroky James T.,
Doyle William J.
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24021
Subject(s) - medicine , logistic regression , eustachian tube , effusion , otitis , adenoidectomy , disease , surgery , prospective cohort study , confounding , cardiology , middle ear , tonsillectomy
Objectives/Hypothesis In children with ventilation tubes (VTs) inserted for chronic otitis media with effusion (COME), the authors sought to determine whether any parameter of Eustachian tube (ET) function measured by the forced response test (FRT) predicts disease recurrence after the VT becomes nonfunctional. Study Design Prospective study of those factors that predict disease recurrence in children with VTs inserted for COME. Methods Forty‐nine subjects (73 ears; 28 male, 34 white, aged 5.3 ± 1.2 years) with COME had VTs inserted and were evaluable for disease status after the VT(s) became nonfunctional. The FRT was done when the VTs were patent, and results for the last test before the VT became nonfunctional were used in the analysis. After each VT became nonfunctional, the children were followed for disease recurrence over a 12‐month period. Logistic regression was used to determine whether the ET opening pressure, closing pressure, and/or dilatory efficiency predicted disease recurrence. That model was expanded to include age, sex, race, history of adenoidectomy, previous VTs, and duration of VT patency as potential predictive factors. Results Twenty‐nine (40%) ears had recurrence of significant disease within 12 months after the VT became nonfunctional. For the complete logistic regression model, male gender ( P = .03), nonwhite race ( P = .02), shorter period of VT patency ( P = .01), and low dilatory efficiency ( P = .01) were significant predictors of disease recurrence. Conclusions A measure of active ET function, dilatory efficiency, but not measures of passive function predicted disease recurrence within the 12 months after the VT became nonfunctional in children with COME. Level of Evidence 4 Laryngoscope , 123:2285–2290, 2013