Association of tympanostomy tubes with future assistive hearing devices–a population based study

Abstract

Background: Ear (tympanostomy) tube (TT) placement is a common ambulatory surgery in children. Despite the commonality of this treatment, the long-term effects are unknown. The objective of this study was to determine the rate of permanent hearing loss, as measured by use of a rehabilitative hearing device. Methods: A retrospective comprehensive population-based cohort study was performed, evaluating all hospitals in the Canadian province of Ontario. Three cohorts of children were constructed: TTat least one ear tube procedure (n = 193,880), No-TT -recurrent visits to a physician for middle ear disease, did not undergo ear tubes (n = 203,283), and Controlan age/sex matched group who had not undergone ear tubes and who didn't have repeat physician visits for middle ear disease (n = 961,168). The main outcome measures were risk and odds ratio (OR) of rehabilitative hearing devices. Results: The TT cohort had a higher risk of obtaining a hearing aid (OR 4.53 vs. No-TT, p < 0.001; OR 10.81 vs. Control, p < 0.001), an FM system (OR 3.84 vs. No-TT, p < 0.001; OR 15.13 vs. Control, p < 0.001), and an implanted bone conduction device (OR 5.08 vs. No-TT, p < 0.001; OR 15.67 vs. Control, p < 0.001). Conclusions: An association between ear tube placement and long-term need for a rehabilitative hearing device was found. This association warrants future prospective research in this area.

Editorial: Otitis Media Genomics and the Middle Ear Microbiome

“…Antibiotics are prescribed for 67–98% of children with OM ( Hersh et al, 2016 ; Frost et al, 2020 ), which contributes to antibiotic resistance and drug-specific adverse effects, even if administered appropriately ( Fleming-Dutra et al, 2016 ; DeMuri et al, 2017 ; Islam et al, 2020 ). 4–10% of children require surgery due to recurrent acute (RA) OM or chronic OM with effusion (COME) ( Beyea et al, 1999 ; Bhattacharyya and Shay, 2020 ). RAOM is diagnosed in children with ≥3 OM episodes in 6 months or ≥4 in 12 months, and COME if ME effusion behind the intact eardrum persists for >2 months ( Rosenfeld et al, 2016 ).…”

“…RAOM is diagnosed in children with ≥3 OM episodes in 6 months or ≥4 in 12 months, and COME if ME effusion behind the intact eardrum persists for >2 months ( Rosenfeld et al, 2016 ). Combined, these OM types and surgery are associated with 4–11× risk of permanent HL ( Rach et al, 1988 ; Beyea et al, 1999 ). RAOM/COME cause defects in language ability, auditory perception, sound localization and auditory processing in 5–11% of school-age children, which impedes academic progress ( Morrongiello, 1989 ; Zargi and Boltezar, 1992 ; Moore, 2007 ; Hind et al, 2011 ; Skarzynski et al, 2015 ; Graydon et al, 2017 ; Cordeiro et al, 2018 ; Leach et al, 2020 ).…”