title: Eustachian tube function as a predictor of the recurrence of middle ear effusion in children.
abstract: OBJECTIVE
  In children with ventilation tubes (VTs) inserted for chronic otitis media with effusion (COME), the authors sought to determine whether any parameter of Eustachian tube (ET) function measured by the forced response test (FRT) predicts disease recurrence after the VT becomes nonfunctional.
  
  
  METHODS
  Prospective study of those factors that predict disease recurrence in children with VTs inserted for COME.
  
  
  METHODS
  Forty-nine subjects (73 ears; 28 male, 34 white, aged 5.3 ± 1.2 years) with COME had VTs inserted and were evaluable for disease status after the VT(s) became nonfunctional. The FRT was done when the VTs were patent, and results for the last test before the VT became nonfunctional were used in the analysis. After each VT became nonfunctional, the children were followed for disease recurrence over a 12-month period. Logistic regression was used to determine whether the ET opening pressure, closing pressure, and/or dilatory efficiency predicted disease recurrence. That model was expanded to include age, sex, race, history of adenoidectomy, previous VTs, and duration of VT patency as potential predictive factors.
  
  
  RESULTS
  Twenty-nine (40%) ears had recurrence of significant disease within 12 months after the VT became nonfunctional. For the complete logistic regression model, male gender (P = .03), nonwhite race (P = .02), shorter period of VT patency (P = .01), and low dilatory efficiency (P = .01) were significant predictors of disease recurrence.
  
  
  CONCLUSIONS
  A measure of active ET function, dilatory efficiency, but not measures of passive function predicted disease recurrence within the 12 months after the VT became nonfunctional in children with COME.
authors.affiliation: Department of Otolaryngology, Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mandel
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Swarts
authors.forename: Margaretha L
authors.initials: ML
authors.lastname: Casselbrant
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Tekely
authors.forename: Beverly C
authors.initials: BC
authors.lastname: Richert
authors.forename: James T
authors.initials: JT
authors.lastname: Seroky
authors.forename: William J
authors.initials: WJ
authors.lastname: Doyle
mesh_terms: D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005064:Eustachian Tube / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects / Q000379:methods*; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000601:surgery*; D038781:Otoscopy / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Eustachian tube function; chronic otitis media with effusion; recurrence