Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T12:25:20.086Z Has data issue: false hasContentIssue false
  • English
  • Français

Tympanostomy in young children with recurrent otitis media. A long-term follow-up study

Published online by Cambridge University Press:  29 June 2007

Hannu Valtonen ,
Yrjö Qvarnberg  and
Juhani Nuutinen
Hannu Valtonen*
Affiliation:
Department of Otorhinolaryngology, Jyväskylä Central Hospital, Finland.
Yrjö Qvarnberg
Affiliation:
Department of Otorhinolaryngology, Jyväskylä Central Hospital, Finland.
Juhani Nuutinen
Affiliation:
Department of Otorhinolaryngology, University Hospitals of Kuopio and Oulu, Finland.
*
Address for correspondence: Hannu J. Valtonen, M.D., Ph.D., Department of Otorhinolaryngology, Jyväskylä Central Hospital, Keskussairaalantie 19, FIN-40620 Jyväskylä, Finland. Fax: +358 14 691098
Get access Rights & Permissions [Opens in a new window]

Abstract

A total of 305 children, five to 16 months of age, were treated from 1983–1984 with ventilation tubes – Shah vent Teflon tube – inserted under local anaesthesia for recurrent acute otitis media (RAOM) or otitis media with effusion (OME). The final study group comprised 281 children (92.1 per cent) monitored prospectively for five years, 185 in the OME-group and 96 in the RAOM-group. For the first insertion of tubes the average ventilation period was 15.4 months. Re-tympanostomy, with adenoidectomy simultaneously at the first time was performed in 99 ears (35.2 per cent); once in 27.0 per cent, twice in five per cent, and three times in 3.2 per cent. Mastoidectomy due to otorrhoea was performed in three ears (1.1 per cent). The children in the OME-group were at higher risk of repeated post-tympanostomy otorrhoea episodes than children in the RAOM-group. These episodes of otorrhoea during the first insertion of ventilation tubes significantly increased both the tube extrusion rate and the need for subsequent re-tympanostomies. No major complications were caused by the tympanostomy procedure as such. It is concluded that early tympanostomy is a safe procedure in young children with RAOM or OME. However, parents should be carefully informed of risks of post-tympanostomy otorrhoea and recurrent disease after insertion of ventilation tubes necessitating subsequent tube insertion, especially in children with OME.

Keywords

Otitis mediaOtitis media with effusionInfantChildMiddle ear ventilationFollow-up studies
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 3 , March 1999 , pp. 207 - 211
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Armstrong, B. W. (1954) A new treatment for chronic secretory otitis media. Archives of Otolaryngology 59: 653–654.CrossRefGoogle ScholarPubMed
Barfoed, C., Rosborg, J. (1980) Secretory otitis media. Long-term observations after treatments with grommets. Archives of Otolaryngology – Head and Neck Surgery 106: 553–556.CrossRefGoogle Scholar
Bulkley, W. J., King Bowes, A., Marlowe, J. (1991) Complications following ventilation of the middle ear using Goode T tubes. Archives of Otolaryngology – Head and Neck Surgery 117: 895–898.CrossRefGoogle ScholarPubMed
Cotton, R. T., Bierman, C. W., Zalzal, G. H. (1984) Serous otitis in children: medical and surgical aspects, diagnosis and management. Clinical Reviews in Allergy 2: 329–348.Google ScholarPubMed
Donaldson, J. D., Martin, G. F., Maltby, C. C., Seywerd, E. B. (1990) The efficacy of pulse-dosed antibiotic therapy in the management of persistent otitis media with effusion. Journal of Otolaryngology 19: 175–178.Google ScholarPubMed
Gates, G. A., Avery, C. A., Prihoda, T. J., Cooper, J. C. Jr. (1987) Effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. New England Journal of Medicine 317: 1444–1451.CrossRefGoogle ScholarPubMed
Gibb, A. G., Mackenzie, I. J. (1985) The extrusion rate of grommets. Otolaryngology – Head and Neck Surgery 93: 695–699.CrossRefGoogle ScholarPubMed
Gonzalez, C., Arnold, J. E., Woody, E. A., Erhardt, J. B., Pratt, S. R., Getts, A., Kueser, T. J., Kolmer, J. W., Sachs, M. (1986) Prevention of recurrent acute otitis media: chemoprophylaxis versus tympanostomy tubes. Laryngoscope 96: 1330–1334.CrossRefGoogle ScholarPubMed
Juola, E. (1988) Effect of adenoidectomy, tympanostomy and sulfisoxazole prophylaxis otitis media in young children. Publications of the University of Kuopio, Medicine. Original reports 5, pp 1–123.Google Scholar
Karma, P., Palva, T., Kouvalainen, K., Kärjä, J., Mäkelä, P. H., Prinssi, P., Ruuskanen, O., Launiala, M. (1987) Finnish approach to the treatment of acute otitis media. Report of the Finnish consensus conference. Annals of Otology, Rhinology and Laryngology (Suppl 129): 1–19.CrossRefGoogle Scholar
Karma, P., Sipilä, M., Kokko, E. (1982) Long-term results of tympanostomy treatment in chronic secretory otitis media. Acta Oto-Laryngologica (Stockhl) (Suppl 386): 163–165.CrossRefGoogle Scholar
Koivuniemi, P. (1988) Secretory otitis media and mastoid pneumatization. A clinical study with long-term follow-up. University Press, Helsinki.Google Scholar
Kokko, E. (1974) Chronic secretory otitis media in children. A clinical study. Acta Oto-Laryngologica (Stockh) (Suppl 327): 1–44.Google ScholarPubMed
Leopold, D., McCabe, B. (1980) Factors influencing tympanostomy tube function and extrusion: A study of 1,127 ears. Otolaryngology – Head and Neck Surgery 88: 447–454.CrossRefGoogle Scholar
Lildholt, T. (1983) Ventilation tubes in secretory otitis media. A randomized, controlled study of the course, the complications, and the sequelae of ventilation tubes. Acta Oto-Laryngologica (Stockh) (Suppl 398): 1–28.Google Scholar
Muenker, G. (1980) Results after treatment of otitis media with effusion. Recent advances in otitis media with effusion. Annals of Otology, Rhinology and Laryngology (Suppl 68): 308–311.CrossRefGoogle Scholar
Palva, T., Virtanen, H., Mäkinen, J. (1985) Acute and latent mastoiditis in children. Journal of Laryngology and Otology 99: 127–136.CrossRefGoogle ScholarPubMed
Paradise, J. L., Bluestone, C. D., Rogers, K. D., Taylor, F. H., Colborn, D. K., Bachman, R. Z., Bernard, B. S., Schwarzbach, R. H. (1990) Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement. Journal of the American Medical Association 263: 2066–2073.CrossRefGoogle ScholarPubMed
Prichard, A. J., Marshall, J., Skinner, D. W., Narula, A. A. (1992) Long-term results of Goode's tympanostomy tubes in children. International Journal of Pediatric Otorhinolaryngology 24: 227–233.CrossRefGoogle ScholarPubMed
Qvarnberg, Y. (1981) Acute otitis media: A prospective clinical study of myringotomy and antimicrobial treatment. Acta Oto-Laryngologica (Stockh) (Suppl 375): 1–157.Google ScholarPubMed
Rothera, M. P., Grant, H. R. (1985) Long-term ventilation of the middle ear using the Goode T-tube. Journal of Laryngology and Otology 99: 335–337.CrossRefGoogle ScholarPubMed
Samuel, J., Rosen, G., Vered, Y. (1979) Use of middle ear ventilation tubes in recurrent acute otitis media. Journal of Laryngology and Otology 93: 979–981.CrossRefGoogle ScholarPubMed
Sederberg-Olsen, J. F., Sederberg-Olsen, A. E., Jensen, A. M. (1989) Late results of treatment with ventilation tubes for secretory otitis media in ENT practice. Acta Oto-Laryngologica (Stockh) 108: 448–455.CrossRefGoogle ScholarPubMed
Sipilä, M. (1991) Occurrence, risk factors and consequences of otitis media in children. Acta Universitatis Tamperensis, Tampere, ser A vol 310.Google Scholar
The Swedish Consensus Conference. (1991) Konsensusuttalande: Barn med öroninflammationer Läkartidningen 88: 2002–2004.Google Scholar
Valtonen, H., Qvarnberg, Y., Puhakka, H., Nuutinen, J. (1997) Early post-tympanostomy otorrhoea in children under 17 months of age. Acta Oto-Laryngologica 117: 569–573.CrossRefGoogle ScholarPubMed
Virolainen, E. (1986) Middle ear ventilation tubes in children with recurrent otitis media. Ten year follow-up study. In Acute and Secretory Otitis Media (Sade, J., ed.) Kugler Publications, Amsterdam, pp 485–491.Google Scholar
Weigel, M. T., Parker, M. Y., Goldsmith, M. M., Postma, D. S., Pillsbury, H. C. (1989) A prospective randomized study of four most commonly used tympanostomy tubes. Laryngoscope 99: 252–256.CrossRefGoogle ScholarPubMed