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Robert Stenstrom, MD, PhD; I. Barry Pless, MD; Philippe Bernard, MD, PhD

Arch Pediatr Adolesc Med. 2005;159:1151-1156.

Objective  To determine the long-term effects of ventilation tube insertion on hearing thresholds and tympanic membrane pathologic abnormalities in children with otitis media with effusion.

Design  Prospective cohort study.

Setting  Tertiary care children’s hospital, otorhinolaryngology and audiology service.

Participants  Patients aged 8 to 16 years who participated in a randomized controlled trial of medical vs surgical (ventilation tube [VT]) treatment for recurrent otitis media with effusion at ages 2.5 to 7 years.

Main Outcome Measures  Hearing thresholds and tympanic membrane sequelae.

Methods  One hundred thirteen of 125 children who had participated in the trial underwent blinded audiometric, tympanometric, otomicroscopic, and parental questionnaire evaluation 6 to 10 years following the trial. Thirty of 56 medical subjects received ventilation tubes and 18 of 57 VT subjects received more than 1 set of tubes. To evaluate sequelae risk associated with ventilation tubes independent of disease severity, we compared 27 medical subjects who never received ventilation tubes and 38 subjects randomized to VT who only received 1 set of tubes.

Results  Tympanic membrane pathologic abnormalities were present in 81% of VT subjects and 19% of medical subjects (relative risk, 4.4; 95% confidence interval, 2.2-9.9). Hearing thresholds were 2.1 to 8.1 dB higher in subjects treated with tubes (P = .005).

Conclusions  In children who were candidates for ventilation tube insertion randomly assigned to receive medical or VT treatment for otitis media with effusion, elevated hearing thresholds and tympanic membrane pathologic abnormalities were more common in VT subjects 6 to 10 years after insertion.

Author Affiliations: Department of Emergency Medicine, St Paul’s Hospital, Vancouver, British Columbia (Dr Stenstrom), Department of Emergency Medicine, British Columbia Women’s and Children’s Hospital, Vancouver (Dr Stenstrom), Faculty of Medicine, University of British Columbia, Vancouver (Dr Stenstrom), Montreal Children’s Hospital, Montreal, Quebec (Dr Pless); Department of Epidemiology and Biostatistics, McGill University, Montreal (Dr Pless); Department of Otolaryngology, Children’s Hospital of Eastern Ontario, Ottawa (Dr Bernard), Department of Surgery, University of Ottawa, Ottawa (Dr Bernard).

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Long-term Sequelae of Ventilating Tubes: Implications for Management of Otitis Media With Effusion
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Arch Pediatr Adolesc Med 2005;159:1183-1185.
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