Faculty Collaboration Database

Tracking tympanostomy tube outcomes in pediatric patients with otitis media using an electronic database. Int J Pediatr Otorhinolaryngol 2015 Aug;79(8):1275-8

Date

06/28/2015

Pubmed ID

26115935

DOI

10.1016/j.ijporl.2015.05.029

Scopus ID

2-s2.0-84937162120 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

OBJECTIVE: To implement and review a database for children with a diagnosis of otitis media (OM) to facilitate comparative outcomes and long-term prospective follow up of surgical outcomes. Specific aim is to review presenting symptoms, risk factors, tympanostomy tube outcomes and complications, and need for further procedures.

METHODS: A web-based customized database was constructed to universally enroll all patients seen in consultation with a diagnosis of OM. Unique database fields include demographics, physical exam findings, risk factors, intervention, and long-term outcomes. Major surgical complications measured include: tympanic membrane perforation, retained tubes, chronic otorrhea, and cholesteatoma formation.

RESULTS: Six hundred and thirty four unique patients have been prospectively enrolled. Five hundred and forty four tubes have been followed to extrusion. Outcomes demonstrate high prevalence of OM risk factors associated with surgical patients including: 63% in day care and 26% with a sibling requiring tympanostomy tubes. Complication rates; 1% developed perforations requiring surgical intervention, 2.6% required removal of retained tubes, 1% extruded early (<60 days), and 0.7% were surgically removed for other complications. Cholesteatoma was identified in 0.56%, all had ongoing chronic ear disease.

CONCLUSIONS: Long-term, outcome driven investigations assessing the surgical management of OM are needed given the prevalence of this disease and the frequency of surgical intervention required. The current database represents the largest prospective cohort of patients enrolled and followed in this fashion and has generated data demonstrating a procedure associated with significant improvement in patient quality of life in the short-term with low complication rates in the long-term. This ongoing prospective investigation is providing data that have the potential to be important in treatment algorithms, procedure justification, and risk factor modification.

Author List

O'Niel MB, Cassidy LD, Link TR, Kerschner JE

Authors

Laura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
T Roxanne Link NP APP Outpatient in the Otolaryngology department at Medical College of Wisconsin

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

Adolescent
Child
Child, Preschool
Cholesteatoma
Databases, Factual
Device Removal
Female
Humans
Infant
Internet
Male
Middle Ear Ventilation
Otitis Media
Prospective Studies
Prostheses and Implants
Prosthesis Failure
Quality of Life
Risk Factors
Treatment Outcome
Tympanic Membrane Perforation