title: The impact of tobacco exposure on development of otorrhea after myringotomy tube placement.
abstract: BACKGROUND
  Otorrhea is a common sequela after myringotomy with tube placement (MTP). The purpose of this study was to identify any significant relationship between passive tobacco exposure and the development of post-tympanostomy tube otorrhea.
  
  
  METHODS
  Retrospective chart review was performed on 774 cases of patients who underwent MTP by a single surgeon at a tertiary pediatric hospital from 2012 to 2014. Patients with multiple medical comorbidities, craniofacial anomalies, syndromes and those over 12 years of age were excluded. Multivariate logistic regression analysis was performed to determine if there was a relationship between risk factors (including tobacco exposure, age, pre-operative diagnosis, operative findings and duration of follow-up) and the development of post-tympanostomy tube otorrhea.
  
  
  RESULTS
  One hundred and ninety-one patients (average age of 1.92 years) were included. Overall, 16.8% of patients (32/191) had exposure to tobacco smoke. Of patients with passive smoke exposure, 65.6% (21/32) developed otorrhea, as compared to 45.3% (72/159) of those without tobacco exposure. Passive exposure to tobacco smoke by (OR = 2.307; p = 0.009; 95% CI, 1.734-6.028) and younger age (p = 0.012; 95% CI, 0.602-0.938) were associated with increased risk for otorrhea.
  
  
  CONCLUSIONS
  This study suggests that in a cohort of patients undergoing MTP, passive exposure to tobacco smoke significantly increases the risk of developing post-operative otorrhea. This information is valuable to include in parental preoperative counseling regarding tympanostomy tube placement.
authors.affiliation: University of Arkansas for Medical Sciences, Department of Otolaryngology-Head and Neck Surgery, 4301 W. Markham, Slot 543, Little Rock, AR, 72205, USA. Electronic address: JEGlancybizzell@uams.edu.
authors.forename: Jamie G
authors.initials: JG
authors.lastname: Bizzell
authors.affiliation: University of Arkansas for Medical Sciences, Department of Otolaryngology-Head and Neck Surgery, 4301 W. Markham, Slot 543, Little Rock, AR, 72205, USA. Electronic address: MDCox@uams.edu.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Cox
authors.affiliation: University of Arkansas for Medical Sciences College of Medicine, 4301 W. Markham Street, Little Rock, AR, 72205, USA. Electronic address: RAWang@uams.edu.
authors.forename: Annie R
authors.initials: AR
authors.lastname: Wang
authors.affiliation: University of Arkansas for Medical Sciences, Department of Otolaryngology-Head and Neck Surgery, 4301 W. Markham, Slot 543, Little Rock, AR, 72205, USA; Arkansas Children's Hospital, Division of Pediatric Otolaryngology, 1 Children's Way, Slot 836, Little Rock, AR, 72202, USA. Electronic address: GTRichter@uams.edu.
authors.forename: Gresham T
authors.initials: GT
authors.lastname: Richter
authors.affiliation: University of Arkansas for Medical Sciences, Department of Otolaryngology-Head and Neck Surgery, 4301 W. Markham, Slot 543, Little Rock, AR, 72205, USA; Arkansas Children's Hospital, Division of Pediatric Otolaryngology, 1 Children's Way, Slot 836, Little Rock, AR, 72202, USA. Electronic address: NolderAbbyR@uams.edu.
authors.forename: Abby R
authors.initials: AR
authors.lastname: Nolder
mesh_terms: D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008876:Middle Ear Ventilation; D015999:Multivariate Analysis; D016017:Odds Ratio; D010033:Otitis Media / Q000601:surgery; D010034:Otitis Media with Effusion / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Myringotomy; Otitis media; Otorrhea; Smoking; Tobacco; Tube