Association of tympanostomy tubes with future risk of advanced ear surgery – a population study

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.