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Year : 2018  |  Volume : 20  |  Issue : 2  |  Page : 62-67

Recurrent Tympanostomy Tube Insertion for Chronic Otitis Media with Effusion in Children and the Effect of Concurrent Adenoidectomy on the Outcome.

1 ENT Consultant, Otology and Cochlear Implant Surgeon. Former Head of Cochlear Implant Programme, King Fahad Hospital, Jeddah, Saudi Arabia
2 Otolaryngology Senior Resident, King Abulaziz University Hospital, Jeddah, Saudi Arabia
3 Otolaryngology Resident, Ministry of Health, Jeddah, Saudi Arabia

Correspondence Address:
MD Abdulmonem Al-Shaikh
P.O.Box 10462, Jeddah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-8491.273923

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Purpose: To determine the incidence of recurrent tube insertion in our region and to study the effect of adenoidectomy in concurrent with 1st tube insertion surgery on the outcome in our target population. Methods: Retrospective medical chart review was performedfor all children between the age of 6 mo-12 years, who underwent tympanostomy tube insertion due to otitis media 2014 at a referral hospital; Otolaryngology specialized center at King Fahad Hospital, Jeddah, Saudi Arabia. Information regarding initial and repeated tympanostomy tube placement from the medical records. Because of incomplete records for at risk children (children at risk for otitis media with effusion due to presence of bronchial asthma, Down’s syndrome, cleft palate, craniofacial malformation), all at risk children were excluded from our analysis. To study the effect of age and gender on the need for repeated sets of tube insertion, our population was divided in two groups as follow: Group A (children from 6mo to 4years; n= 131) and Group B (children form 4 years and 12 years; n= 232). To study the effect of adenoidectomy in concurrence with first set of tube insertion; our population was divided further into two groups: group I (tube insertion + adenoidectomy) and group II (tube insertion alone). Results: Three hundred and sixty three children were included in this study. Forty six (12.7%) of the 363 children who underwent initial tympanostomy tube insertion subsequently required another set of tubes insertion as follows: thirty one (8.5%) children required two sets of tube insertion, fourteen (3.9%) required three sets, one child (0.3%) required four sets. Age and gender showed a non significant difference between the two groups, group A and group B(Chi-square =0.73, P = 0.24; Chi-square = 0.28, P= 0.35 respectively). A total of 208 out of 363 patients underwent adenoidectomy in concurrent with the first set of tube insertion. One eighty seven (89.9%) of them required only one set; 21(10.1%) required more than one set. The remaining 155 patients underwent tubes insertion alone, without adenoidectomy. One thirty (83.9%) of them required only one set; 25(16.1%) required more than one set. There were no significant difference between the two groups, group I and group II, in regard to both the need for repeated use and the frequency of tube usage (chi-square = 2.91, 4.71, P = 0.087, 0.195 respectively) Conclusions: In our region, repeated use of tympanostomy tube insertion for otitis media with effusion carry a considerable incidence. Adenoidectomy performed at the fist set of tube insertion does not show a significant effect on the risk of repeated tube insertion. In as well as potential risk factors for otitis media were extracted addition, age (at the first tube insertion) and gender have no clear role on the need for repeated tube usage.

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