Association of Tympanostomy Tubes With Future Risk of Advanced Ear Surgery-A Population Study.

ABSTRACT

OBJECTIVE: To investigate future surgery for chronic ear disease in children who underwent tympanostomy tube (TT) placement, compared with non-surgically treated patients and healthy controls. STUDY DESIGN: Retrospective population-based cohort study. SETTING: All hospitals in the Canadian province of Ontario. PATIENTS/INTERVENTION Of children aged 18 years and younger, three cohorts were constructed 1) TT patients who had undergone at least one TT procedure (n = 193,880), 2) No-TT patients with recurrent physician visits for middle ear concerns who did not undergo TT (n = 203,283), and 3) Control an age-sex matched control group who had not had TT or physician visits for recurrent middle ear concerns (n = 961,168). MAIN OUTCOME MEASURES: Risk, and odds ratios (ORs) of surgery for chronic ear disease. RESULTS: The TT cohort had a higher risk of tympanoplasty (OR 9.50 versus No-TT, p < 0.001; OR 207.90 versus Control, p < 0.001), ossiculoplasty (OR 3.22 versus No-TT, p < 0.001; OR 84.13 versus Control, p < 0.001), atticotomy (OR 4.41 versus No-TT, p < 0.001; OR 44.78 versus Control, p < 0.001), and mastoidectomy (OR 3.22 versus No-TT, p < 0.001; OR 89.12 versus control, p < 0.001). CONCLUSION: This study describes the population risk of subsequent ear surgeries in TT patients. These TT patients have a significantly higher risk of surgery for chronic ear disease versus those patients with recurrent middle ear disease that did not undergo TT, and age-sex matched controls.