title: Clinical manifestations and risk factors of children receiving triple ventilating tube insertions for treatment of recurrent otitis media with effusion.
abstract: OBJECTIVE
  Our goal was to determine risk factors for children receiving additional ventilating tube insertions after initial tube insertion and to determine the changes of clinical manifestations in children who have undergone 3 ventilating tube insertion procedures.
  
  
  METHODS
  We retrospectively analyzed medical and operation records of 423 young patients who had ventilating tube insertion because of chronic otitis media with effusion from January 1993 to December 1998. The single-operation group included patients who had 1 ventilating tube insertion only, and the triple-operation group included patients who received ventilating tube insertion 3 times because of recurring chronic otitis media with effusion.
  
  
  RESULTS
  At the first operation, there were significant differences between the single- and triple-operation groups in mean age, the proportion who received a concurrent adenoidectomy, the mean indwelling period of the first ventilating tube, the proportion who developed postoperative otorrhea within 1 month, and the proportion who had early extrusion of the ventilating tube within 3 months of surgery. In the triple-operation group, the accumulated number of adenoidectomies, the indwelling period of the ventilating tube, and the time interval before subsequent ventilating tube insertion after ventilating tube extrusion significantly increased as ventilating tube insertion procedures were performed repeatedly. Although there was no difference when compared with the single-operation group, the proportion of glue-like effusion significantly decreased as ventilating tube insertion procedures were performed repeatedly. There were no significant differences between the single- and triple-operation groups in male/female ratio, site of ventilating tube insertion, and the proportion of patients with glue-like effusion at the first ventilating tube insertion.
  
  
  CONCLUSIONS
  The probability of receiving additional ventilating tube insertion because of recurrent otitis media with effusion significantly increased in younger patients at the time of first ventilating tube insertion. The concurrent adenoidectomy, duration of the ventilating tube, postoperative otorrhea within 1 month, and early extrusion of the ventilating tube also influenced the probability of additional ventilating tube insertion.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
authors.forename: Joong Ho
authors.initials: JH
authors.lastname: Ahn
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Yoon
authors.forename: Ki Hoon
authors.initials: KH
authors.lastname: Pae
authors.forename: Tae Su
authors.initials: TS
authors.lastname: Kim
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Chung
authors.forename: Kwang-Sun
authors.initials: KS
authors.lastname: Lee
mesh_terms: D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data; D010034:Otitis Media with Effusion / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors