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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 II

이준호|이승환|이지혜|정재호|박시내|정종우|서재현|김규성|최준|한규철|이규엽|김동기|박홍주|문인석|조양선|정연훈|유명훈|전범조|여승근
대한이비인후과학회 (Korean Society of Otorhinolaryngology-Head and Neck Surgery)|2022.11|Clinical and Experimental Otorhinolaryngology|제15권 제4호|pp. 326-334|DOI https://doi.org/10.21053/ceo.2022.00934

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참고문헌

키워드

TitaniumComplicationRecurrenceSiliconeOtitis MediaTympanostomy Tube

초록

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.

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.

참고문헌 (30)

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관련 논문AI추천

Factors Affecting the Extrusion Rate of Ventilation Tubes김영호, 박민현, 송창면, 이준호대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2010 · 제3권 제2호소아 환자에서 중이 환기관 재삽입과 관련된 임상적 특징 및 환기관삽입술 후 합병증공수근, 권하늬, 김석현, 오세준, 이일우, 이현민대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2023 · 제66권 제10호Microbiological Results From Middle Ear Effusion in Pediatric Patients Receiving Ventilation Tube Insertion: Multicenter Registry Study on the Effectiveness of Ventilation Tube Insertion in Pediatric Patients With Chronic Otitis Media With Effusion: Part I최준, 김규성, 김동기, 문인석, 박시내, 박홍주, 서재현, 여승근, 유명훈, 이규엽, 이승환, 이준호, 이지혜, 전범조, 전은주, 정연훈, 정재호, 정종우, 조양선, 한규철대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2018 · 제11권 제3호Risk factors for persistent otitis media with effusion in children: a case-control study김세형, 김영리, 김윤주, 송찬일, 이주연, 최재홍영남대학교 의과대학 · Journal of Yeungnam Medical Science2018 · 제35권 제1호삼출성 중이염으로 환기관삽입술을 받은 소아에서 중이삼출액 내의 면역세포 유형과 환기관 이루 발생의 관계김동영, 송찬일, 임길채, 최승효, 현창림대한이비인후과학회 · 대한이비인후과학회지 두경부외과학2018 · 제61권 제3호Management for the Children with Otitis Media with Effusion in the Tertiary Hospital강희선, 박기현, 박헌이, 신유리, 이종빈, 정연훈, 최성준, 한동희대한이비인후과학회 · Clinical and Experimental Otorhinolaryngology2008 · 제1권 제4호

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