Variables associated with repeated ventilation tube insertion in healthy non-syndromic children
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OBJECTIVES: The objectives of this study was to determine variables associated with rVT insertions for rAOM and/or OME in otherwise healthy children. METHODS: This was designed as a retrospectively controlled cohort study. Patients were identified from a prospectively collected surgical database. Eligible subjects were those who had undergone rVT and a consecutive concurrent control group who received only one ventilation tube (VT). Exclusion criteria included craniofacial abnormalities and syndromes. Demographics, tympanic membrane characteristics, parental smoking, breast-feeding history, large day-care attendance, and soother use was collected. RESULTS: Over a period of 10 years, 59 patients underwent rVT (5.6%). 180 children who underwent VT were included in the control group. There was no difference in gender distribution (p=1, 1.73:1 vs. 1.76:1), mean age (p=0.69, 4.7±3.33 vs. 4.4±3.17) or chronic rhinitis (p=0.36, OR 1.376, 95% CI: 0.69-2.74). The rVT group was associated significantly more with a smoking parent (p=0, OR 61.8, 95% CI 21.26-176.07), large day care attendance (p=0, OR 23.39, 95% CI: 8.637-57.54), breast feeding <3months (p=0, OR -0.074, 95% CI: 0.028-0.331), soother use (p=0, OR 21.49, 95% CI: 7.81-55.87), and tympanic membrane atelectasis (p<0.0005). The same factors were also found to be significant upon multiple regression analysis (p<0.05). CONCLUSIONS: Otherwise healthy children with rAOM and/or OME are at a greater risk of rVT if they attend large day cares, were not breast fed for ≥3 months, if their tympanic membranes were atelectatic and most significantly if their parents smoke.
