title: Impact of Otitis Media Severity on Children's Quality of Life.
abstract: Children with otitis media (OM) suffer sleep disturbances, loss of appetite, earache, and behavioral problems. Our objective was to quantitate the average burden of OM and to compare the associated impact of tympanostomy tubes on infant health related quality of life (HR-QoL).
  
  
  
  Multi-institutional prospective cross-sectional study.
  
  
  
  Otolaryngology, family practice, and pediatric clinics.
  
  
  
  Children ages 6 to 24 months of age with or without recurrent OM. Patient history, the PedsQL Infant QoL survey, and the 6-item child with OM survey (Otitis Media 6 [OM-6]) were collected from providers and parents.
  
  
  
  Data from 1208 patients were analyzed. Mean age was 14.7 months, and 54% were male. The mean OM-6 score of children with recurrent OM was 3.3, whereas similarly aged well-children had a mean OM-6 score of 2.5. The mean PedsQL Infant scores of recurrent OM patients were significantly worse than those of children from well-child visits. Worse OM-6 scores were correlated with poorer PedsQL Infant scores, Pearson r = -0.581 (1-12 months) and -0.558 (13-24 months), P < .001. Otolaryngology patients who were recommended to undergo ear tube placement had significantly poorer OM-6 scores and worse PedsQL Infant scores, whereas patients with prior tube placement had significantly better OM-6 and PedsQL Infant scores.
  
  
  
  Children with recurrent OM had significantly worse HR-QoL than similarly aged healthy children. Increased burden of OM strongly affected HR-QoL, and recommendation for tube placement was associated with increased disease burden and poorer HR-QoL. The presence of tympanostomy tubes was associated with better OM-6 and PedsQL Infant scores.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Grindler
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Blank
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Schulz
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Witsell
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA lieuj@ent.wustl.edu.
authors.forename: Judith E C
authors.initials: JE
authors.lastname: Lieu
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000150:complications* / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: acute otitis media; otitis media with effusion; pressure equalization tube; quality of life; recurrent otitis media; tympanostomy tube