EPIDEMIOLOGY OF PRESSURE REGULATION. INCIDENCE OF VENTILATION TUBE TREATMENTS AND ITS PRELIMINARY CORRELATION TO SUBSEQUENT EAR SURGERY

Purpose: Treatment with ventilation tubes (VT) in secretory otitis media and related conditions is a very common procedure based on the rationale of equilibrating the middle ear pressure (MEP) with ambient. Repeated VT treatments are also common in more severe cases, which increase the risk of permanent perforation of the tympanic membrane. The purpose of the present study was to describe the current incidence of VT treatments in children (< 15 years) during 2000 to 2005 in a Danish County as well as the number of children subsequently admitted to a tertiary hospital setting for subsequent reconstructive ear surgery. Materials and Methods: Database information was obtained from the County Health Authorities with information on all VT treatments in children in primary otological practices for the period. Cross reference of this information for year 2000 was made with our database on ear surgery for the identification of patients, who subsequently had been referred for surgery to our department. Results: The incidence of VT insertions was determined for the group of children born in 2000 and followed for a 6-year period. The incidence peaked between the age of I to 2 years at 137 per 1,000 children, while the cumulated incidence was 28 %. Repeated insertions were found amounting to 45, 22, and 11 % for 2(nd), 3(rd) and 4(th)+ insertions, respectively. A total of 3544 children were treated with one or more VTs in 2000; in the following observation period 40 of these were identified in our department. A total of 45 surgical procedures were performed in these children: 39 myringoplasties (87 %), 5 tympanoplasty type II (11 %), 1 tympanoplasty type III (2 %); cholesteatoma was found in 9 cases (20 %). Conclusions: The incidence of VT insertions was high amounting to 28 % by the age of 6 years. Reinsertions were also high and likely to be correlated to subsequent referrals of patients for reconstructive otosurgery. During our limited period of follow up only few children (1 %) were submitted for ear surgery, where the majority had simple myringoplasties (87 %), while the remaining cases consisted of more severe cases with structural damage. Future studies including a longer observation period will increase this number and provide measures of the correlation between the incidence of VT insertions and reinsertions and the need for subsequent otosurgery reflecting complications and sequelae of SOM and VT. Such numbers describe a more complete measure of the epidemiological weight of SOM and the necessity of basic research in MEP regulation.