title: Long-term follow-up of otitis media with effusion in children: comparisons between a ventilation tube group and a non-ventilation tube group.
abstract: OBJECTIVE
  The objective of this study was to investigate the long-term outcomes in children with otitis media with effusion who received either medical treatment or ventilation tubes.
  
  
  METHODS
  We retrospectively analyzed the medical records of 89 bilateral cases of otitis media with effusion in children who were recommended to receive ventilation tube insertion and were followed up for more than 5 years. Tympanic membrane was inspected by otoscopic examination. Hearing was evaluated with pure tone audiometry. The mean duration of follow-up was 8.4 years (range, 5.2-15.7 years). Twenty-three children were treated without surgery, while 22 were treated once by ventilation tube insertion and 44 were treated more than once by ventilation tube insertion.
  
  
  RESULTS
  At the fifth year of follow-up, both groups of children who underwent ventilation tube insertion had more frequent tympanic membrane abnormalities than the medication group (8.7% in those treated without surgery, 72.7% in those treated once by ventilation tube insertion, and 88.6% in those treated more than once by ventilation tube insertion). Common tympanic membrane abnormalities were retraction (27.0%) and tympanosclerotic plaque (23.6%), regardless of the treatment modality. At the fifth year follow-up, the average air-conduction threshold was 10.0 dB (± 6.5 dB) in patients treated without surgery, 15.9 dB (± 11.2dB) in patients treated once by ventilation tube insertion, and 17.8 dB (± 7.6 dB) in those treated more than once by ventilation tube insertion. The audiological difference was significant when we compared the hearing level of children treated by medication without surgery to the two ventilation tube groups.
  
  
  CONCLUSIONS
  Though ventilation tube insertion can resolve hearing loss quickly, there were more tympanic membrane abnormalities and a decline in hearing levels in our ventilation tube insertion group vs. the observation group measured 5 years later. Physicians should therefore be cautious when applying a ventilation tube in patients with otitis media with effusion and should explain the risks to patients who are a candidate for repeated ventilation tube insertion.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Hong
authors.affiliation: Department of Otolaryngology, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
authors.forename: Tae Su
authors.initials: TS
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: jwchung@amc.seoul.kr.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Chung
mesh_terms: D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects / Q000379:methods*; D010034:Otitis Media with Effusion / Q000601:surgery*; D038781:Otoscopy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology / Q000601:surgery
keywords: Children; Hearing loss; Medical treatment; Otitis media with effusion; Ventilation tube