Factors Affecting the Extrusion Rate and Complications After Ventilation Tube Insertion: A Multicenter Registry Study on the Effectiveness of Ventilation Tube Insertion in Pediatric Patients With Chronic Otitis Media With Effusion-Part IIopen access
- Authors
- 유명훈; 정종우; 조양선; 최준; 정연훈; 정재호; 한규철; 전범조; 김동기; 김규성; 이준호; 이규엽; 이승환; 문인석; 박홍주; 박시내; 이지혜; 서재현; 여승근
- Issue Date
- Nov-2022
- Publisher
- 대한이비인후과학회
- Keywords
- Otitis Media; Tympanostomy Tube; Recurrence; Titanium; Silicone; Complication
- Citation
- Clinical and Experimental Otorhinolaryngology, v.15, no.4, pp.326 - 334
- Journal Title
- Clinical and Experimental Otorhinolaryngology
- Volume
- 15
- Number
- 4
- Start Page
- 326
- End Page
- 334
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/87226
- DOI
- 10.21053/ceo.2022.00934
- ISSN
- 1976-8710
- Abstract
- Objectives. The impacts of ventilation tube (VT) type and effusion composition on the VT extrusion rate and complications in children with otitis media remain unclear. This part II study evaluated the factors affecting the extrusion rate, recurrence rate, and complications of VT insertion.
Methods. A prospective study was conducted between June 2014 and December 2016 (the EVENT study [analysis of the effectiveness of ventilation tube insertion in pediatric patients with chronic otitis media]), with follow-up data collected until the end of 2017. Patients aged <15 years diagnosed with otitis media with effusion who received VT insertion were recruited at 15 tertiary hospitals. The primary outcomes were time to extrusion of VT, time to effusion recurrence, and complications.
Results. Data from 401 patients were analyzed. After excluding the results of long-lasting tubes (Paparella type II and T-tubes), silicone tubes (Paparella type I) exhibited a significantly longer extended time to extrusion (mean, 400 days) than titanium tubes (collar-button-type 1.0 mm: mean, 312 days; P<0.001). VT material (hazard ratio [HR], 2.117, 95% confidence interval [CI], 1.254–3.572; P=0.005), age (HR, 3.949; 95% CI, 1.239–12.590; P=0.02), and effusion composition (P=0.005) were significantly associated with the time to recurrence of middle ear effusion. Ears with purulent (mean, 567 days) and glue-like (mean, 588 days) effusions exhibited a shorter time to recurrence than ears with serous (mean, 846 days) or mucoid (mean, 925 days) effusions. The revision VT rates during follow-up were 3.5%, 15.5%, 10.4%, and 38.9% in ears with serous, mucoid, glue-like, and purulent effusions, respectively (P<0.001). The revision surgery rates were higher among patients aged <7 years than among those aged ≥7 years.
Conclusion. Silicone tubes (Paparella type I) were less prone to early extrusion than titanium 1.0 mm tubes. VT type, patient age, and effusion composition affected the time to recurrence of effusion.
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