The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion

M. P. Haggard; M. M. Gannon; J. A. Birkin; K. E. Bennett; E. E. Nicholls; H. Spencer; G. G. Browning; J. M. Higson; S. C. Smith; S. E. Hind; M. M. Rovers; E. M. Egner; T. Hayman; D. C. Greenwood; R. A. Carroll; H. Jones; T. B. Richmond; A. R. Wade; P. Moorjani; D. A.S. Pearson; G. Kirk; J. L. Baskill; D. A. Adams; J. G. Toner; K. P. Gibbin; N. S. Jones; J. P. Birchall; R. S.A. Thomas; A. A. Narula; G. E. Murty; M. V. Griffiths; J. A. Wilson; D. Meikle; I. J.M. Johnson; S. Date; A. I.G. Kerr; D. Robinson; G. Madden; P. D. Bull; D. F. Chapman; A. J. Parker; A. R. Curry; R. G. Williams; M. S.C. Morrissey; N. K. Geddes; A. P. Zarod; D. J. Willatt; D. Proops; K. Pearman; P. J. Robb; I. MacKee; K. Law; M. Casey; A. Megarry; L. Smith; H. Smethurst; G. Pearce; P. Hook; J. Phipps; S. Gibbs; S. Dunster; E. Brown; E. M. Birch; V. Page; A. Sim; G. Sharples; J. Crawford; C. Davies; J. Bartolo; C. Edwards; J. Wilson; N. Johnson; C. Baxendale; W. Welsby; N. Pickavance; V. Cox; K. Markham; J. A. Robb; R. Flanagan; G. Housten; G. Jordan; M. Bingham; J. Cassidy; C. Bums; C. Hamill; L. Glover; L. Eccles; G. Armstrong-Bednall; B. Towle; K. Dyer; J. Carr; J. Herrod; A. Levick; P. Dunmore; C. Parker-Emery; R. Sutton; C. Gordon; L. Midgley; N. Barnett

doi:10.1046/j.1365-2273.2003.00680.x

The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion

M. P. Haggard, M. M. Gannon, J. A. Birkin, K. E. Bennett, E. E. Nicholls, H. Spencer, G. G. Browning^*, J. M. Higson, S. C. Smith, S. E. Hind, M. M. Rovers, E. M. Egner, T. Hayman, D. C. Greenwood, R. A. Carroll, H. Jones, T. B. Richmond, A. R. Wade, P. Moorjani, D. A.S. PearsonG. Kirk, J. L. Baskill, D. A. Adams, J. G. Toner, K. P. Gibbin, N. S. Jones, J. P. Birchall, R. S.A. Thomas, A. A. Narula, G. E. Murty, M. V. Griffiths, J. A. Wilson, D. Meikle, I. J.M. Johnson, S. Date, A. I.G. Kerr, D. Robinson, G. Madden, P. D. Bull, D. F. Chapman, A. J. Parker, A. R. Curry, R. G. Williams, M. S.C. Morrissey, N. K. Geddes, A. P. Zarod, D. J. Willatt, D. Proops, K. Pearman, P. J. Robb, I. MacKee, K. Law, M. Casey, A. Megarry, L. Smith, H. Smethurst, G. Pearce, P. Hook, J. Phipps, S. Gibbs, S. Dunster, E. Brown, E. M. Birch, V. Page, A. Sim, G. Sharples, J. Crawford, C. Davies, J. Bartolo, C. Edwards, J. Wilson, N. Johnson, C. Baxendale, W. Welsby, N. Pickavance, V. Cox, K. Markham, J. A. Robb, R. Flanagan, G. Housten, G. Jordan, M. Bingham, J. Cassidy, C. Bums, C. Hamill, L. Glover, L. Eccles, G. Armstrong-Bednall, B. Towle, K. Dyer, J. Carr, J. Herrod, A. Levick, P. Dunmore, C. Parker-Emery, R. Sutton, C. Gordon, L. Midgley, N. Barnett

^*Corresponding author for this work

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Abstract

The study determined the effects on hearing of the status of ventilation tubes, using a combination of otoscopy and tympanometry to determine function, in children managed for bilateral persistent otitis media with effusion (OME). The subjects were aged between 3.5 and 7 years and had a documented history of bilateral OME over a 12-week watchful waiting period associated with a hearing impairment in both ears of ≥20 dB HL. The children reported are those randomized to the two surgical arms, both of which had bilateral myringotomy, aspiration of middle ear fluid and insertion of Shepard ventilation tubes. One arm furthermore received adenoidectomy. The data were analysed 'as treated' to document therapeutic progress. Tubes confirmed to be functioning on otoscopy and tympanometry only partially alleviate the conductive impairment associated with childhood OME (AC mean 12 dB HL, SD 4; ABG 13 dB, SD 7, 3 months post operation). Thus, children with a functioning ventilation tube cannot be considered to have 'normal' hearing. Once the tube has extruded, ears that no longer have OME still have a small conductive hearing impairment (at 12 months AC 14 dB HL, SD 6; ABG 16 dB, SD 9) but this improves with time. In children with bilateral tubes, both remain functioning for a median duration of 21 weeks (IQR 10-40) and at least one fora for a median of 40 weeks (IQR 24-61). Tube blockage significantly (P = 0.001) increases the risk of extrusion (84% versus 44%). When inserted in children between 3.5 and 7 years for OME, the otoscopic incidence of tube infection is low (1%).

Original language	English
Pages (from-to)	146-153
Number of pages	8
Journal	Clinical Otolaryngology and Allied Sciences
Volume	28
Issue number	2
DOIs	https://doi.org/10.1046/j.1365-2273.2003.00680.x
Publication status	Published - Apr 2003

Keywords

Acoustic impedance
Hearing
Otitis media with effusion
Surgery
Ventilation tube

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10.1046/j.1365-2273.2003.00680.x

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Haggard, M. P., Gannon, M. M., Birkin, J. A., Bennett, K. E., Nicholls, E. E., Spencer, H., Browning, G. G., Higson, J. M., Smith, S. C., Hind, S. E., Rovers, M. M., Egner, E. M., Hayman, T., Greenwood, D. C., Carroll, R. A., Jones, H., Richmond, T. B., Wade, A. R., Moorjani, P., ... Barnett, N. (2003). The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion. Clinical Otolaryngology and Allied Sciences, 28(2), 146-153. https://doi.org/10.1046/j.1365-2273.2003.00680.x

@article{9a01615ae10b4ef388012b69ba26aacb,

title = "The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion",

abstract = "The study determined the effects on hearing of the status of ventilation tubes, using a combination of otoscopy and tympanometry to determine function, in children managed for bilateral persistent otitis media with effusion (OME). The subjects were aged between 3.5 and 7 years and had a documented history of bilateral OME over a 12-week watchful waiting period associated with a hearing impairment in both ears of ≥20 dB HL. The children reported are those randomized to the two surgical arms, both of which had bilateral myringotomy, aspiration of middle ear fluid and insertion of Shepard ventilation tubes. One arm furthermore received adenoidectomy. The data were analysed 'as treated' to document therapeutic progress. Tubes confirmed to be functioning on otoscopy and tympanometry only partially alleviate the conductive impairment associated with childhood OME (AC mean 12 dB HL, SD 4; ABG 13 dB, SD 7, 3 months post operation). Thus, children with a functioning ventilation tube cannot be considered to have 'normal' hearing. Once the tube has extruded, ears that no longer have OME still have a small conductive hearing impairment (at 12 months AC 14 dB HL, SD 6; ABG 16 dB, SD 9) but this improves with time. In children with bilateral tubes, both remain functioning for a median duration of 21 weeks (IQR 10-40) and at least one fora for a median of 40 weeks (IQR 24-61). Tube blockage significantly (P = 0.001) increases the risk of extrusion (84% versus 44%). When inserted in children between 3.5 and 7 years for OME, the otoscopic incidence of tube infection is low (1%).",

keywords = "Acoustic impedance, Hearing, Otitis media with effusion, Surgery, Ventilation tube",

author = "Haggard, {M. P.} and Gannon, {M. M.} and Birkin, {J. A.} and Bennett, {K. E.} and Nicholls, {E. E.} and H. Spencer and Browning, {G. G.} and Higson, {J. M.} and Smith, {S. C.} and Hind, {S. E.} and Rovers, {M. M.} and Egner, {E. M.} and T. Hayman and Greenwood, {D. C.} and Carroll, {R. A.} and H. Jones and Richmond, {T. B.} and Wade, {A. R.} and P. Moorjani and Pearson, {D. A.S.} and G. Kirk and Baskill, {J. L.} and Adams, {D. A.} and Toner, {J. G.} and Gibbin, {K. P.} and Jones, {N. S.} and Birchall, {J. P.} and Thomas, {R. S.A.} and Narula, {A. A.} and Murty, {G. E.} and Griffiths, {M. V.} and Wilson, {J. A.} and D. Meikle and Johnson, {I. J.M.} and S. Date and Kerr, {A. I.G.} and D. Robinson and G. Madden and Bull, {P. D.} and Chapman, {D. F.} and Parker, {A. J.} and Curry, {A. R.} and Williams, {R. G.} and Morrissey, {M. S.C.} and Geddes, {N. K.} and Zarod, {A. P.} and Willatt, {D. J.} and D. Proops and K. Pearman and Robb, {P. J.} and I. MacKee and K. Law and M. Casey and A. Megarry and L. Smith and H. Smethurst and G. Pearce and P. Hook and J. Phipps and S. Gibbs and S. Dunster and E. Brown and Birch, {E. M.} and V. Page and A. Sim and G. Sharples and J. Crawford and C. Davies and J. Bartolo and C. Edwards and J. Wilson and N. Johnson and C. Baxendale and W. Welsby and N. Pickavance and V. Cox and K. Markham and Robb, {J. A.} and R. Flanagan and G. Housten and G. Jordan and M. Bingham and J. Cassidy and C. Bums and C. Hamill and L. Glover and L. Eccles and G. Armstrong-Bednall and B. Towle and K. Dyer and J. Carr and J. Herrod and A. Levick and P. Dunmore and C. Parker-Emery and R. Sutton and C. Gordon and L. Midgley and N. Barnett",

year = "2003",

month = apr,

doi = "10.1046/j.1365-2273.2003.00680.x",

language = "English",

volume = "28",

pages = "146--153",

journal = "Clinical Otolaryngology and Allied Sciences",

issn = "0307-7772",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "2",

}

Haggard, MP, Gannon, MM, Birkin, JA, Bennett, KE, Nicholls, EE, Spencer, H, Browning, GG, Higson, JM, Smith, SC, Hind, SE, Rovers, MM, Egner, EM, Hayman, T, Greenwood, DC, Carroll, RA, Jones, H, Richmond, TB, Wade, AR, Moorjani, P, Pearson, DAS, Kirk, G, Baskill, JL, Adams, DA, Toner, JG, Gibbin, KP, Jones, NS, Birchall, JP, Thomas, RSA, Narula, AA, Murty, GE, Griffiths, MV, Wilson, JA, Meikle, D, Johnson, IJM, Date, S, Kerr, AIG, Robinson, D, Madden, G, Bull, PD, Chapman, DF, Parker, AJ, Curry, AR, Williams, RG, Morrissey, MSC, Geddes, NK, Zarod, AP, Willatt, DJ, Proops, D, Pearman, K, Robb, PJ, MacKee, I, Law, K, Casey, M, Megarry, A, Smith, L, Smethurst, H, Pearce, G, Hook, P, Phipps, J, Gibbs, S, Dunster, S, Brown, E, Birch, EM, Page, V, Sim, A, Sharples, G, Crawford, J, Davies, C, Bartolo, J, Edwards, C, Wilson, J, Johnson, N, Baxendale, C, Welsby, W, Pickavance, N, Cox, V, Markham, K, Robb, JA, Flanagan, R, Housten, G, Jordan, G, Bingham, M, Cassidy, J, Bums, C, Hamill, C, Glover, L, Eccles, L, Armstrong-Bednall, G, Towle, B, Dyer, K, Carr, J, Herrod, J, Levick, A, Dunmore, P, Parker-Emery, C, Sutton, R, Gordon, C, Midgley, L & Barnett, N 2003, 'The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion', Clinical Otolaryngology and Allied Sciences, vol. 28, no. 2, pp. 146-153. https://doi.org/10.1046/j.1365-2273.2003.00680.x

TY - JOUR

T1 - The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion

AU - Haggard, M. P.

AU - Gannon, M. M.

AU - Birkin, J. A.

AU - Bennett, K. E.

AU - Nicholls, E. E.

AU - Spencer, H.

AU - Browning, G. G.

AU - Higson, J. M.

AU - Smith, S. C.

AU - Hind, S. E.

AU - Rovers, M. M.

AU - Egner, E. M.

AU - Hayman, T.

AU - Greenwood, D. C.

AU - Carroll, R. A.

AU - Jones, H.

AU - Richmond, T. B.

AU - Wade, A. R.

AU - Moorjani, P.

AU - Pearson, D. A.S.

AU - Kirk, G.

AU - Baskill, J. L.

AU - Adams, D. A.

AU - Toner, J. G.

AU - Gibbin, K. P.

AU - Jones, N. S.

AU - Birchall, J. P.

AU - Thomas, R. S.A.

AU - Narula, A. A.

AU - Murty, G. E.

AU - Griffiths, M. V.

AU - Wilson, J. A.

AU - Meikle, D.

AU - Johnson, I. J.M.

AU - Date, S.

AU - Kerr, A. I.G.

AU - Robinson, D.

AU - Madden, G.

AU - Bull, P. D.

AU - Chapman, D. F.

AU - Parker, A. J.

AU - Curry, A. R.

AU - Williams, R. G.

AU - Morrissey, M. S.C.

AU - Geddes, N. K.

AU - Zarod, A. P.

AU - Willatt, D. J.

AU - Proops, D.

AU - Pearman, K.

AU - Robb, P. J.

AU - MacKee, I.

AU - Law, K.

AU - Casey, M.

AU - Megarry, A.

AU - Smith, L.

AU - Smethurst, H.

AU - Pearce, G.

AU - Hook, P.

AU - Phipps, J.

AU - Gibbs, S.

AU - Dunster, S.

AU - Brown, E.

AU - Birch, E. M.

AU - Page, V.

AU - Sim, A.

AU - Sharples, G.

AU - Crawford, J.

AU - Davies, C.

AU - Bartolo, J.

AU - Edwards, C.

AU - Wilson, J.

AU - Johnson, N.

AU - Baxendale, C.

AU - Welsby, W.

AU - Pickavance, N.

AU - Cox, V.

AU - Markham, K.

AU - Robb, J. A.

AU - Flanagan, R.

AU - Housten, G.

AU - Jordan, G.

AU - Bingham, M.

AU - Cassidy, J.

AU - Bums, C.

AU - Hamill, C.

AU - Glover, L.

AU - Eccles, L.

AU - Armstrong-Bednall, G.

AU - Towle, B.

AU - Dyer, K.

AU - Carr, J.

AU - Herrod, J.

AU - Levick, A.

AU - Dunmore, P.

AU - Parker-Emery, C.

AU - Sutton, R.

AU - Gordon, C.

AU - Midgley, L.

AU - Barnett, N.

PY - 2003/4

Y1 - 2003/4

N2 - The study determined the effects on hearing of the status of ventilation tubes, using a combination of otoscopy and tympanometry to determine function, in children managed for bilateral persistent otitis media with effusion (OME). The subjects were aged between 3.5 and 7 years and had a documented history of bilateral OME over a 12-week watchful waiting period associated with a hearing impairment in both ears of ≥20 dB HL. The children reported are those randomized to the two surgical arms, both of which had bilateral myringotomy, aspiration of middle ear fluid and insertion of Shepard ventilation tubes. One arm furthermore received adenoidectomy. The data were analysed 'as treated' to document therapeutic progress. Tubes confirmed to be functioning on otoscopy and tympanometry only partially alleviate the conductive impairment associated with childhood OME (AC mean 12 dB HL, SD 4; ABG 13 dB, SD 7, 3 months post operation). Thus, children with a functioning ventilation tube cannot be considered to have 'normal' hearing. Once the tube has extruded, ears that no longer have OME still have a small conductive hearing impairment (at 12 months AC 14 dB HL, SD 6; ABG 16 dB, SD 9) but this improves with time. In children with bilateral tubes, both remain functioning for a median duration of 21 weeks (IQR 10-40) and at least one fora for a median of 40 weeks (IQR 24-61). Tube blockage significantly (P = 0.001) increases the risk of extrusion (84% versus 44%). When inserted in children between 3.5 and 7 years for OME, the otoscopic incidence of tube infection is low (1%).

AB - The study determined the effects on hearing of the status of ventilation tubes, using a combination of otoscopy and tympanometry to determine function, in children managed for bilateral persistent otitis media with effusion (OME). The subjects were aged between 3.5 and 7 years and had a documented history of bilateral OME over a 12-week watchful waiting period associated with a hearing impairment in both ears of ≥20 dB HL. The children reported are those randomized to the two surgical arms, both of which had bilateral myringotomy, aspiration of middle ear fluid and insertion of Shepard ventilation tubes. One arm furthermore received adenoidectomy. The data were analysed 'as treated' to document therapeutic progress. Tubes confirmed to be functioning on otoscopy and tympanometry only partially alleviate the conductive impairment associated with childhood OME (AC mean 12 dB HL, SD 4; ABG 13 dB, SD 7, 3 months post operation). Thus, children with a functioning ventilation tube cannot be considered to have 'normal' hearing. Once the tube has extruded, ears that no longer have OME still have a small conductive hearing impairment (at 12 months AC 14 dB HL, SD 6; ABG 16 dB, SD 9) but this improves with time. In children with bilateral tubes, both remain functioning for a median duration of 21 weeks (IQR 10-40) and at least one fora for a median of 40 weeks (IQR 24-61). Tube blockage significantly (P = 0.001) increases the risk of extrusion (84% versus 44%). When inserted in children between 3.5 and 7 years for OME, the otoscopic incidence of tube infection is low (1%).

KW - Acoustic impedance

KW - Hearing

KW - Otitis media with effusion

KW - Surgery

KW - Ventilation tube

UR - http://www.scopus.com/inward/record.url?scp=0346997037&partnerID=8YFLogxK

U2 - 10.1046/j.1365-2273.2003.00680.x

DO - 10.1046/j.1365-2273.2003.00680.x

M3 - Article

C2 - 12680834

AN - SCOPUS:0346997037

SN - 0307-7772

VL - 28

SP - 146

EP - 153

JO - Clinical Otolaryngology and Allied Sciences

JF - Clinical Otolaryngology and Allied Sciences

IS - 2

ER -

The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion

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