title: Variables associated with repeated ventilation tube insertion in healthy non-syndromic children.
abstract: OBJECTIVE
  The objectives of this study was to determine variables associated with rVT insertions for rAOM and/or OME in otherwise healthy children.
  
  
  METHODS
  This was designed as a retrospectively controlled cohort study. Patients were identified from a prospectively collected surgical database. Eligible subjects were those who had undergone rVT and a consecutive concurrent control group who received only one ventilation tube (VT). Exclusion criteria included craniofacial abnormalities and syndromes. Demographics, tympanic membrane characteristics, parental smoking, breast-feeding history, large day-care attendance, and soother use was collected.
  
  
  RESULTS
  Over a period of 10 years, 59 patients underwent rVT (5.6%). 180 children who underwent VT were included in the control group. There was no difference in gender distribution (p=1, 1.73:1 vs. 1.76:1), mean age (p=0.69, 4.7±3.33 vs. 4.4±3.17) or chronic rhinitis (p=0.36, OR 1.376, 95% CI: 0.69-2.74). The rVT group was associated significantly more with a smoking parent (p=0, OR 61.8, 95% CI 21.26-176.07), large day care attendance (p=0, OR 23.39, 95% CI: 8.637-57.54), breast feeding <3months (p=0, OR -0.074, 95% CI: 0.028-0.331), soother use (p=0, OR 21.49, 95% CI: 7.81-55.87), and tympanic membrane atelectasis (p<0.0005). The same factors were also found to be significant upon multiple regression analysis (p<0.05).
  
  
  CONCLUSIONS
  Otherwise healthy children with rAOM and/or OME are at a greater risk of rVT if they attend large day cares, were not breast fed for ≥3 months, if their tympanic membranes were atelectatic and most significantly if their parents smoke.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Han
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada; Departments of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Alrajhi
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada; Departments of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. Electronic address: hamdy.elhakim@albertahealthservices.ca.
authors.forename: Hamdy
authors.initials: H
authors.lastname: El-Hakim
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000359:Aftercare; D000416:Alberta; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data*; D010033:Otitis Media / Q000209:etiology / Q000601:surgery*; D010034:Otitis Media with Effusion / Q000209:etiology / Q000601:surgery; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Otitis media; Risk factors; Ventilation tube