Risk Factors for Hearing Loss in the Setting of Pressure Equalization Tube Placement in Children

Abstract

Objectives:

Pressure equalization tube (PET) placement is the most common surgical procedure performed during childhood. Current Academy guidelines recommend more aggressive management of children with otitis media with effusion (OME) who are at greater risk for speech-language and developmental problems. This study was designed to examine risk factors for continued hearing loss following PET placement in children with chronic OME. A large clinical sample ascertained through electronic medical records is used.

Methods:

All pediatric patients undergoing PET-placement between January 2009 andOctober 2012 at a tertiary-care children’s hospital who had audiometric tests were included. Demographics and patient diagnoses (craniofacial anomalies, allergies, prematurity, developmental delay, and speech-language delay) were extracted. A multivariate regression model was used to identify an association between patient-specific characteristics and the presence of pre- or postoperative hearing loss.

Results:

4083 children with 4792 visits were included (2433 males and 1650 females; mean age of 3.4 years). 1007 preoperative and 2655 postoperative audiograms were performed. In addition to known risk factors and patient diagnoses, male gender, younger age, and lower acoustic admittance were associated with preoperative hearing loss (P = 0.03; P = 0.01; P < 0.001). Postoperative hearing loss was associated with patient age, preoperative hearing loss, and lower equivalent canal volumes (P < 0.0001; P = 0.0078; P = 0.0035). Race and ethnicity were not determined to be risk factors.

Conclusions:

The results of this study identify several demographic and patient-specific risk factors for hearing loss surrounding PET placement. These data may have important preoperative counseling and postoperative management implications.