Otological and audiological outcomes five years after tympanostomy in early childhood.
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.


METHODS
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.
Valtonen
Hannu J
HJ
Department of Otorhinolaryngology, Kuopio University Hospital, Finland. hannu.valtonen@kuh.fi
Qvarnberg
Yrjö H
YH
Nuutinen
Juhani
J
D000208:Acute Disease; D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000503:physiopathology* / Q000601:surgery; D010034:Otitis Media with Effusion / Q000503:physiopathology* / Q000601:surgery; D019720:Otoscopes; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome