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Otological and Audiological Outcomes Five Years After Tympanostomy in Early Childhood
Author(s) -
Valtonen Hannu J.,
Qvarnberg Yrjö H.,
Nuutinen Juhani
Publication year - 2002
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 - 10.1097/00005537-200204000-00014
Subject(s) - medicine , otitis , effusion , perforation , prospective cohort study , audiology , conductive hearing loss , tympanic membrane perforation , hearing loss , surgery , tympanoplasty , materials science , punching , metallurgy
Objective Ventilation tubes in the treatment of otitis media in young children remain controversial. Despite abundant research, few prospective long‐term follow‐up studies have included even a minority of patients under 1 year old. We investigated long‐term otological and audiological outcomes in children with recurrent acute otitis media and otitis media with effusion, who were treated early with ventilation tubes. Study Design Prospective follow‐up. Methods Three hundred five children under 17 months of age received a primary tympanostomy in the Central Hospital of Central Finland (Jyväskylä, Finland), and those 281 (92.1%) who were monitored prospectively for 5 years made up the study group. At the final examination, pneumatic otoscope and otomicroscope were used and pure‐tone audiometric thresholds of air and bone conduction were measured to define the hearing levels (mean of 0.5, 1.0, and 2.0 KHz thresholds). Results Of ears, 67.3% were healed, 7.1% had a retraction of tympanic membrane in pars flaccida and 9.6% in pars tensa, 7.5% had an ongoing otitis media with effusion, 3.9% had a ventilation tube in place, and 4.6% had a tympanic membrane perforation with mean hearing levels of 7.6, 9.0, 16.0, 18.5, 10.5, and 17.7 dB, respectively. Conclusions Hearing in general was well preserved, and no ear presented with adhesive otitis media or cholesteatoma. Adverse otological and audiological outcomes of these young children did not exceed those presented by others for older counterparts. Tympanic membrane perforations, ongoing otitis media with effusion, and pars tensa retractions were causes of mild conductive hearing loss. Because one third of ears continued to have middle ear disease or sequelae, we emphasize the proper follow‐up and restoration of middle ear ventilation with repeat ventilation tubes if not otherwise achieved.