title: Parent-reported otorrhea in children with tympanostomy tubes: incidence and predictors.
abstract: OBJECTIVE
  Although common in children with tympanostomy tubes, the current incidence of tympanostomy tube otorrhea (TTO) is uncertain. TTO is generally a sign of otitis media, when middle ear fluid drains through the tube. Predictors for otitis media are therefore suggested to have predictive value for the occurrence of TTO.
  
  
  OBJECTIVE
  To determine the incidence of TTO and its predictors.
  
  
  METHODS
  We performed a cohort study, using a parental web-based questionnaire to retrospectively collect data on TTO episodes and its potential predictors from children younger than 10 years of age with tympanostomy tubes.
  
  
  RESULTS
  Of the 1,184 children included in analyses (total duration of time since tube placement was 768 person years with a mean of 7.8 months per child), 616 children (52%) experienced one or more episodes of TTO. 137 children (12%) had TTO within the calendar month of tube placement. 597 (50%) children had one or more acute TTO episodes (duration <4 weeks) and 46 children (4%) one or more chronic TTO episodes (duration ≥4 weeks). 146 children (12%) experienced recurrent TTO episodes. Accounting for time since tube placement, 67% of children developed one or more TTO episodes in the year following tube placement. Young age, recurrent acute otitis media being the indication for tube placement, a recent history of recurrent upper respiratory tract infections and the presence of older siblings were independently associated with the future occurrence of TTO, and can therefore be seen as predictors for TTO.
  
  
  CONCLUSIONS
  Our survey confirms that otorrhea is a common sequela in children with tympanostomy tubes, which occurrence can be predicted by age, medical history and presence of older siblings.
authors.affiliation: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. t.m.a.vandongen@umcutrecht.nl
authors.forename: Thijs M A
authors.initials: TM
authors.lastname: van Dongen
authors.forename: Geert J M G
authors.initials: GJ
authors.lastname: van der Heijden
authors.forename: Hanneke G
authors.initials: HG
authors.lastname: Freling
authors.forename: Roderick P
authors.initials: RP
authors.lastname: Venekamp
authors.forename: Anne G M
authors.initials: AG
authors.lastname: Schilder
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects*; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D010034:Otitis Media with Effusion / Q000453:epidemiology* / Q000209:etiology*; D010290:Parents; D011379:Prognosis; D016016:Proportional Hazards Models