title: Chronic otitis media surgery and re-operation risk factor analysis: A nationwide retrospective cohort study of 18 895 patients.
abstract: CONCLUSIONS
  Patients with risk factors including younger age, mastoiditis, external ear disease, treatment by older surgeons, and concomitant mastoidectomy should receive detailed management to minimize the probability of re-operation for chronic otitis media (COM).
  
  
  OBJECTIVE
  Although COM remains a common ear disease requiring surgical intervention, its re-operation risks are less well-documented. This study aimed to compare patients with COM who underwent re-operation and those patients with no re-operation, and identify the risks of re-operation.
  
  
  METHODS
  This retrospective cohort study analyzed the trend of COM surgery from 1999-2009, and identified the re-operation risks of 18 895 patients with COM who underwent surgery from 2002-2006 using the National Health Insurance Research Database in Taiwan.
  
  
  RESULTS
  Among the study population, 129 patients underwent revision surgery during a 5.5 ± 1.5 year follow-up period. A univariate logistic regression analysis showed that the re-operation rate was significantly higher in patients under 18 years of age, those with mastoiditis, disorders of external ear, treatment by surgeons of 50-64 years of age, use of a very high volume surgeon, and combined surgery with mastoidectomy. A multivariate analysis further limited the re-operation risk factors to younger patients, those with mastoiditis, external ear disorders, treatment by older surgeons, and concomitant mastoidectomy.
authors.affiliation: a Department of Otolaryngology Head & Neck Surgery , Taipei Veterans General Hospital , Taipei , Taiwan ;|b Department of Otolaryngology , National Yang-Ming University School of Medicine , Taipei , Taiwan ;
authors.forename: Chien-Fu
authors.initials: CF
authors.lastname: Yeh
authors.affiliation: c Department of Otolaryngology , Taipei City Hospital , Taipei , Taiwan ;
authors.forename: Chuan-Song
authors.initials: CS
authors.lastname: Wu
authors.affiliation: a Department of Otolaryngology Head & Neck Surgery , Taipei Veterans General Hospital , Taipei , Taiwan ;|b Department of Otolaryngology , National Yang-Ming University School of Medicine , Taipei , Taiwan ;
authors.forename: Chii-Yuan
authors.initials: CY
authors.lastname: Huang
authors.affiliation: d School of Health Care Administration, Taipei Medical University , Taipei , Taiwan.
authors.forename: Chao-Hsiun
authors.initials: CH
authors.lastname: Tang
authors.affiliation: a Department of Otolaryngology Head & Neck Surgery , Taipei Veterans General Hospital , Taipei , Taiwan ;
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Kuo
authors.affiliation: a Department of Otolaryngology Head & Neck Surgery , Taipei Veterans General Hospital , Taipei , Taiwan ;|b Department of Otolaryngology , National Yang-Ming University School of Medicine , Taipei , Taiwan ;
authors.forename: Tzong-Yang
authors.initials: TY
authors.lastname: Tu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Tympanoplasty; mastoidectomy; population-based study; revision