title: Risk factors associated with postoperative tympanostomy tube obstruction.
abstract: OBJECTIVE
  Myringotomy and tympanostomy tube placement for chronic otitis media with effusion is the most common reason for a child to undergo anesthesia in the United States. Postoperative tube obstruction occurs in 1.4% to 36.0% of cases and remains a challenge in achieving middle ear ventilation.
  
  
  OBJECTIVE
  To identify risk factors associated with tube obstruction.
  
  
  METHODS
  Retrospective medical record review of 248 patients, mean age 2.54 years, seen between March 2007 and June 2011 in a tertiary care pediatric hospital.
  
  
  METHODS
  Tympanostomy tube placement and postoperative otic drop therapy.
  
  
  METHODS
  Tube patency at postoperative visit, number of tube removals and revisions, age, sex, body mass index (BMI), middle ear fluid type at time of surgery, and time between surgery and first postoperative visit were examined. Type of surgery (tympanostomy tube placement alone, adenoidectomy + tympanostomy tube placement, tympanostomy tube placement + adenoidectomy + tonsillectomy) and its effect on tube patency were also reviewed.
  
  
  RESULTS
  At first follow-up, 10.6% of patients had occlusion of one or both tubes. No significant association was found between tube patency and a patient's BMI percentile, sex, or procedure type. Patients with no middle ear fluid were more likely to have patent tubes than those who had serous fluid (odds ratio [OR], 3.5; 95% CI, 1.2-10.6; P = .02). A significant inverse correlation was found between patency and time between surgery and follow-up in that patients who had longer follow-up after surgery were less likely to have patent tubes (OR per day of follow-up delay, 0.990; 95% CI, 0.981-0.999; P = .01).
  
  
  CONCLUSIONS
  Tympanostomy tube obstruction was seen in 10.6% of patients. Serous fluid and increased time to postoperative visit were statistically significant indicators for tube occlusion.
authors.affiliation: Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware2Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: David E
authors.initials: DE
authors.lastname: Conrad
authors.affiliation: Department of Otolaryngology, Boston University Hospital, Boston, Massachusetts.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Levi
authors.affiliation: Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware.
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Theroux
authors.affiliation: Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware.
authors.forename: Yell
authors.initials: Y
authors.lastname: Inverso
authors.affiliation: Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware2Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania4Department of Pediatrics, Thomas Jeffers.
authors.forename: Udayan K
authors.initials: UK
authors.lastname: Shah
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects*; D010034:Otitis Media with Effusion / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors