Epidemiology of Tympanoplasty in Children following Tympanostomy Tube Placement

Abstract

Objectives:

Quantify the incidence rate of tympanoplasty after tympanostomy tube (TT) insertion in children.

Methods:

This was a retrospective cohort study of healthy children <18 years old using Medicaid Extract Files from 1999 to 2004. All subjects received TTs and had at least 6 months continuous Medicaid eligibility prior to TTs. We followed patients for 2 years after TTs. The Kaplan-Meier procedure was used to estimate time to tympanoplasty.

Results:

There were 270,408 children with billing records for TTs, and 141,243 met inclusion criteria with a follow-up time of 217,431 patient-years. Median age at TTs was 1.62 year, with 58.5% placed at <2 years. Subsequent tympanoplasty was performed in 963 (0.68%), with 324 at age 2-4 years. The median age at tympanoplasty was 5.1 years. Median time from TTs to tympanoplasty was 450 days. The incidence rate of tympanoplasty was 44 cases per 10,000 patient-years (95% confidence interval 41 to 47).

Conclusions:

Tympanoplasty following TTs is not uncommon. These repairs are commonly performed in preschool children and often within 2 years of TT placement.