title: Follow-up audiometry after bilateral myringotomy and tympanostomy tube insertion.
abstract: OBJECTIVE
  There are no evidence-based guidelines regarding timing of postoperative audiometric follow-up for children undergoing tympanostomy tube insertion. Given the variability of follow-up among physicians, we attempt to guide the timing of postoperative audiograms using objective data.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  All pediatric patients undergoing primary bilateral myringotomy and tympanostomy tube insertion for otitis media with effusion who had audiometric data available at two follow-up times were identified from 2014. Patients were classified according to the type of audiometry performed and were further categorized into those who had tympanostomy tube insertion only and those who had concurrent adenotonsillectomies.
  
  
  RESULTS
  34 patients were included in the study. Among patients assessed by sound field audiometry, the mean sound field threshold value was 29.2dB preoperatively and improved to 21dB 2 weeks postoperatively and 17.9dB 6 to 10 weeks postoperatively. The difference between the two postoperative means was significant (p<0.0001). For patients evaluated by pure-tone audiometry, the mean preoperative air-bone gap was 20.1dB; this improved to 10dB at the first postoperative visit and 7.3dB at the second visit. The difference between the two means was significant (p<0.0001). For the subgroups in which adjunct adenotonsillectomy was performed, the greater improvement at the later follow-up was still statistically significant.
  
  
  CONCLUSIONS
  Progressive hearing improvement was demonstrated from 2 weeks to 6 to 10 weeks postoperatively. We recommend testing no fewer than 6 weeks after tympanostomy tube insertion. Earlier audiometry underestimates the degree of hearing improvement.
authors.affiliation: Department of Otolaryngology, New York Medical College, Valhalla, NY, United States.
authors.forename: Shirley
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States. Electronic address: nepatel@nyee.edu.
authors.forename: Neha A
authors.initials: NA
authors.lastname: Patel
authors.affiliation: Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States.
authors.forename: Shai
authors.initials: S
authors.lastname: Shinhar
mesh_terms: D000233:Adenoidectomy; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D014068:Tonsillectomy; D016896:Treatment Outcome
keywords: Audiology; Follow-up; Grommet; Tympanostomy tubes