title: Recurrent tube insertion for chronic otitis media with effusion in children over 6 years.
abstract: OBJECTIVE
  The purpose of this study is to identify the clinical characteristics of children above 6 years of age with chronic otitis media with effusion (COME) who have required pressure equalizing tube (PET) insertions.
  
  
  METHODS
  A retrospective chart review was performed of all children above the age of 6 years, who underwent PET insertion due to chronic OME, between 2000 and 2009 at a tertiary care institution. Children were also divided into those with a single PET and those with ≥ 2 PET. Comparison of various characteristics between the two groups was undertaken.
  
  
  RESULTS
  290 children were identified as having at least one PET insertion after the age of 6 years. 45.5% of the children underwent a single PET insertion while 54.5% underwent 2 procedures or more. No significant gender-based difference was observed. In those patients requiring ≥ 2 PET, 65.2% also underwent tonsillectomy and/or adenoidectomy compared to only 53.8% of children with a single PET intervention (p<0.05). Asthma, trisomy 21 and cleft palate, were more common in those children who had undergone ≥ 2 PET (p<0.001, p<0.01 and p<0.05, respectively).
  
  
  CONCLUSIONS
  Children above 6 years of age who have undergone ≥ 2 PET insertions for COME demonstrated an increased rate of tonsillectomy and adenoidectomy. Trisomy 21, cleft palate and particularly, asthma, were also found to be risk factors for COME necessitating ≥ 2 PET insertions.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Cinzia L
authors.initials: CL
authors.lastname: Marchica
authors.forename: Jacob
authors.initials: J
authors.lastname: Pitaro
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Daniel
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods*; D010034:Otitis Media with Effusion / Q000601:surgery*; D012189:Retrospective Studies; D014068:Tonsillectomy