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Deborah S. F. Kacmarynski, MD; Samuel C. Levine, MD; Susan E. Pearson, MD; Robert H. Maisel, MD

Arch Otolaryngol Head Neck Surg. 2004;130:289-292.

Objectives  To report the incidence of short-term complications from otitis media in children before placement of tympanostomy tubes (TTs) and to compare children treated according to the Agency for Health Care Policy and Research guidelines with those who were treated earlier or later than recommended.

Design  Retrospective outcomes review.

Patients  Subjects were children aged 10 or younger who had TTs inserted at a tertiary care county hospital from January 1, 1999, to December 31, 2000. Exclusion criteria included prior TT placement, any concurrent head and neck procedure, and craniofacial defects.

Intervention  Tympanostomy tube placement.

Main Outcome Measures  Any occurrences of otorrhea, tympanic membrane perforation, tinnitus, antibiotic reactions, speech or language delay, febrile seizures, or meningitis before placement of TTs documented in the county hospital records were recorded as complications. Hearing loss was considered separately.

Results  Of 147 children who met our criteria, 81 (55.1%) had 1 or more complications from otitis media before placement of TTs. Fifty-five (37.4%) had 2 to 6 complications documented. Adverse reactions to antibiotics were the most common complication, reported in 34 (23.1%).

Conclusions  Most children in this county hospital experienced short-term complications of otitis media before receiving TTs. Even the children treated "on time" according to the guidelines from the Agency for Health Care Policy and Research experienced complications; however, adherence to the guidelines had no significant effect on complications.

From the Department of Otolaryngology (Drs Kacmarynski and Levine), Division of Otology (Dr Levine), University of Minnesota, and Department of Otolaryngology, Hennepin County Medical Center (Dr Maisel), Minneapolis, Minn; and the Department of Otolaryngology, Division of Pediatric Otolaryngology, Children's National Medical Center, Washington, DC (Dr Pearson). The authors have no relevant financial interest in this article.

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