Faculty Collaboration Database

Disease severity in patients referred to pediatric otolaryngologists with a diagnosis of otitis media. Int J Pediatr Otorhinolaryngol 2006 Feb;70(2):311-7

Date

08/30/2005

Pubmed ID

16125250

DOI

10.1016/j.ijporl.2005.07.001

Scopus ID

2-s2.0-30144442533 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

OBJECTIVE: This study evaluated disease severity of children referred to a pediatric otolaryngology practice with a diagnosis of otitis media (OM) before and after tympanostomy tube (TT) placement.

METHODS: A retrospective review was conducted of patients referred to a pediatric otolaryngology practice from January 2000 to April 2004, with the chief complaint of middle ear effusion (MEE) and/or OM. Patients who underwent TT placement had pre- and post-operative hearing levels (HL) and bilaterality of disease analyzed.

RESULTS: A total of 286 patients who underwent TT placement were included. Recurrent OM (ROM) was the most common diagnosis (42.6%), followed by OM with effusion (OME) plus ROM (ROM + OME) (31.7%) and then OME (25.7%) alone. The mean improvement in the pure tone average (PTA) hearing level was 14.8 dB in patients with OME, 9.5 dB in patients with ROM + OME and 6.3 dB in patients with ROM alone. The hearing improvements in OME and ROM + OME were statistically larger than the ROM group (P < or =0.0004). Hearing levels at 500, 1000, 2000 Hz and PTA showed statistically significant improvements in HL after tube placement in each group (P < 0.0001). Of the patients presenting with OME or ROM + OME, 70% had pre-operative findings demonstrating bilateral MEE.

CONCLUSION: Most children referred for consideration of surgical management of OM have a diagnosis of ROM, or ROM in conjunction with OME, with only a small percentage having the diagnosis of OME alone. In addition, the majority of children have bilateral disease, suggesting a more severely affected patient population treated by the pediatric otolaryngologist. The results also demonstrate a significant improvement in hearing after the placement of TT. However, the long-term impact of this hearing improvement on a child's development is not known and an additional prospective study of children in this population group is warranted.

Author List

Poetker DM, Ubell ML, Kerschner JE

Authors

Joseph E. Kerschner MD Provost, Executive Vice President, Dean, Professor in the School of Medicine Administration department at Medical College of Wisconsin
David M. Poetker MD Chief, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acoustic Impedance Tests
Audiometry, Pure-Tone
Child, Preschool
Developmental Disabilities
Female
Hearing Loss, Conductive
Humans
Male
Middle Ear Ventilation
Otitis Media with Effusion
Otolaryngology
Otoscopy
Recurrence
Referral and Consultation
Retrospective Studies
Severity of Illness Index
Treatment Outcome