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Editorial |

Long-term Sequelae of Ventilating Tubes:  Implications for Management of Otitis Media With Effusion

Stephen Berman, MD
Arch Pediatr Adolesc Med. 2005;159(12):1183-1185. doi:10.1001/archpedi.159.12.1183.
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The article entitled “Hearing Thresholds and Tympanic Membrane Sequelae in Children Managed Medically or Surgically for Otitis Media With Effusion” by Stenstrom, et al1 published in this issue of the ARCHIVES increases our understanding of the long-term adverse effects of ventilating tubes (VTs) for otitis media with effusion (OME). The Ottawa, Ontario, study describes the findings of a 6- to 9-year follow-up assessment in 113 of 125 children enrolled in a randomized, controlled trial that compared the surgical insertion of T-type VTs with antibiotic prophylaxis to manage OME. This initial trial enrolled children aged 2.5 to 7 years who had evidence of unilateral or bilateral OME for at least 3 months and a hearing threshold greater than 25 dB in at least 1 of the affected ears. The long-term follow-up assessments included a parent survey, medical record review, otoscopic examination, and audiologic testing. The parent survey included demographic factors, level of satisfaction with the OME treatment that their child received in the study, the number of viral upper respiratory infections and ear complaints that the child had in the preceding 12 months, the history of allergies, second-hand smoke exposure, and school performance. A medical record review to document the number of acute otitis media episodes and VT insertions included both the primary care site and the hospital. Investigators who performed the otoscopic examinations as well as hearing and tympanometry audiology assessments were unaware of the subjects’ history (blinded), and the subjects were called back for these assessments in random order to avoid seasonal bias. Tympanic membrane (TM) abnormalities identified by otoscopy included tympanosclerosis and other pathologic abnormalities such as perforation, retraction pocket, and focal atelectasis.

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