title: Tracking tympanostomy tube outcomes in pediatric patients with otitis media using an electronic database.
abstract: OBJECTIVE
  To implement and review a database for children with a diagnosis of otitis media (OM) to facilitate comparative outcomes and long-term prospective follow up of surgical outcomes. Specific aim is to review presenting symptoms, risk factors, tympanostomy tube outcomes and complications, and need for further procedures.
  
  
  METHODS
  A web-based customized database was constructed to universally enroll all patients seen in consultation with a diagnosis of OM. Unique database fields include demographics, physical exam findings, risk factors, intervention, and long-term outcomes. Major surgical complications measured include: tympanic membrane perforation, retained tubes, chronic otorrhea, and cholesteatoma formation.
  
  
  RESULTS
  Six hundred and thirty four unique patients have been prospectively enrolled. Five hundred and forty four tubes have been followed to extrusion. Outcomes demonstrate high prevalence of OM risk factors associated with surgical patients including: 63% in day care and 26% with a sibling requiring tympanostomy tubes. Complication rates; 1% developed perforations requiring surgical intervention, 2.6% required removal of retained tubes, 1% extruded early (<60 days), and 0.7% were surgically removed for other complications. Cholesteatoma was identified in 0.56%, all had ongoing chronic ear disease.
  
  
  CONCLUSIONS
  Long-term, outcome driven investigations assessing the surgical management of OM are needed given the prevalence of this disease and the frequency of surgical intervention required. The current database represents the largest prospective cohort of patients enrolled and followed in this fashion and has generated data demonstrating a procedure associated with significant improvement in patient quality of life in the short-term with low complication rates in the long-term. This ongoing prospective investigation is providing data that have the potential to be important in treatment algorithms, procedure justification, and risk factor modification.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Mallory B
authors.initials: MB
authors.lastname: O'Niel
authors.affiliation: Institute for Health and Society, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Cassidy
authors.affiliation: Division of Pediatric Otolaryngology, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226, USA; Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: T Roxanne
authors.initials: TR
authors.lastname: Link
authors.affiliation: Division of Pediatric Otolaryngology, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226, USA; Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9000 W Wisconsin Avenue, Milwaukee, WI 53226, USA. Electronic address: jkerschner@mcw.edu.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Kerschner
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002781:Cholesteatoma / Q000453:epidemiology; D016208:Databases, Factual; D020878:Device Removal; D005260:Female; D006801:Humans; D007223:Infant; D020407:Internet; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects; D010033:Otitis Media / Q000453:epidemiology / Q000601:surgery*; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects; D011475:Prosthesis Failure; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology
keywords: Complication rate; Otitis media; Tympanostomy tubes