Parent-reported otorrhea in children with tympanostomy tubes: incidence and predictors

Thijs M A van Dongen, Geert J M G van der Heijden, Hanneke G Freling, Roderick P Venekamp, Anne G M Schilder, Thijs M A van Dongen, Geert J M G van der Heijden, Hanneke G Freling, Roderick P Venekamp, Anne G M Schilder

Abstract

Purpose: Although common in children with tympanostomy tubes, the current incidence of tympanostomy tube otorrhea (TTO) is uncertain. TTO is generally a sign of otitis media, when middle ear fluid drains through the tube. Predictors for otitis media are therefore suggested to have predictive value for the occurrence of TTO.

Objective: To determine the incidence of TTO and its predictors.

Methods: We performed a cohort study, using a parental web-based questionnaire to retrospectively collect data on TTO episodes and its potential predictors from children younger than 10 years of age with tympanostomy tubes.

Results: Of the 1,184 children included in analyses (total duration of time since tube placement was 768 person years with a mean of 7.8 months per child), 616 children (52%) experienced one or more episodes of TTO. 137 children (12%) had TTO within the calendar month of tube placement. 597 (50%) children had one or more acute TTO episodes (duration <4 weeks) and 46 children (4%) one or more chronic TTO episodes (duration ≥4 weeks). 146 children (12%) experienced recurrent TTO episodes. Accounting for time since tube placement, 67% of children developed one or more TTO episodes in the year following tube placement. Young age, recurrent acute otitis media being the indication for tube placement, a recent history of recurrent upper respiratory tract infections and the presence of older siblings were independently associated with the future occurrence of TTO, and can therefore be seen as predictors for TTO.

Conclusions: Our survey confirms that otorrhea is a common sequela in children with tympanostomy tubes, which occurrence can be predicted by age, medical history and presence of older siblings.

Conflict of interest statement

Competing Interests: AS has received an honorarium from GlaxoSmithKline for participating in educational activities and workshops related to pneumococcal vaccination and otitis media. She has received funds from GlaxoSmithKline for research on microbial pathogens in acute tympanostomy tube otorrhoea. The other authors have declared that no competing interests exist. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1. Kaplan-Meier curve for the duration…
Figure 1. Kaplan-Meier curve for the duration between tube placement and the occurrence of a first TTO episode.

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