RT Journal
A1 Stenstrom R, Pless I, Bernard P
T1 HEaring thresholds and tympanic membrane sequelae in children managed medically or surgically for otitis media with effusion
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2005
FD December 1
VO 159
IS 12
SP 1151
OP 1156
DO 10.1001/archpedi.159.12.1151
UL http://dx.doi.org/10.1001/archpedi.159.12.1151
AB 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.