Hearing thresholds and tympanic membrane sequelae in children managed medically or surgically for otitis media with effusion.
OBJECTIVE
To determine the long-term effects of ventilation tube insertion on hearing thresholds and tympanic membrane pathologic abnormalities in children with otitis media with effusion.


METHODS
Prospective cohort study.


METHODS
Tertiary care children's hospital, otorhinolaryngology and audiology service.


METHODS
Patients aged 8 to 16 years who participated in a randomized controlled trial of medical vs surgical (ventilation tube [VT]) treatment for recurrent otitis media with effusion at ages 2.5 to 7 years.


METHODS
Hearing thresholds and tympanic membrane sequelae.


METHODS
One hundred thirteen of 125 children who had participated in the trial underwent blinded audiometric, tympanometric, otomicroscopic, and parental questionnaire evaluation 6 to 10 years following the trial. Thirty of 57 [corrected] medical subjects received ventilation tubes and 18 of 56 [corrected] VT subjects received more than 1 set of tubes. To evaluate sequelae risk associated with ventilation tubes independent of disease severity, we compared 27 medical subjects who never received ventilation tubes and 38 subjects randomized to VT who only received 1 set of tubes.


RESULTS
Tympanic membrane pathologic abnormalities were present in 81% of VT subjects and 19% of medical subjects (relative risk, 4.4; 95% confidence interval, 2.2-9.9). Hearing thresholds were 2.1 to 8.1 dB higher in subjects treated with tubes (P = .005).


CONCLUSIONS
In children who were candidates for ventilation tube insertion randomly assigned to receive medical or VT treatment for otitis media with effusion, elevated hearing thresholds and tympanic membrane pathologic abnormalities were more common in VT subjects 6 to 10 years after insertion.
Stenstrom
Robert
R
Department of Emergency Medicine, St Paul's Hospital, Vancouver, British Columbia, Canada. rstenstrom@providencehealth.bc.ca
Pless
I Barry
IB
Bernard
Philippe
P
D000293:Adolescent; D001299:Audiometry; D001309:Auditory Threshold / Q000502:physiology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects*; D010034:Otitis Media with Effusion / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology* / Q000503:physiopathology