Ventilation Tube Treatment

Hellström, Sten; Groth, Anita; Jørgensen, F; Pettersson, Agneta; Ryding, Marie; Uhlén, Inger; Boström, Kristina Bengtsson

doi:10.1177/0194599811409862

Cited by 110 publications

(25 citation statements)

References 87 publications

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“…4, 31 Most children who received PET placement in this study would have had placement prior to 2013. Prior to 2013, reviews of the literature disagreed on whether enough evidence existed to conclude that that PET placement reduced episodes of AOM during the first six months after placement, 20-22 but all agreed that there was not evidence to make conclusions about impact after six months. Together, the findings of higher rates of PET in white children from this study, that white children are more likely to receive PET for RAOM, and varying conclusions in the literature and guidelines about the use of PET placement for RAOM may suggest overuse of PET in white children, although further research would be needed to make this conclusion with certainty.…”

Section: Discussionmentioning

confidence: 99%

“…However, since those studies, there have been important changes in the healthcare landscape surrounding PET tube placement, including changes in their utilization due to pneumococcal vaccination, 12-15 changes in children's health insurance coverage over the intervening time period, 16, 17 increased focus on disparities in healthcare, 18, 19 the release of relevant clinical practice guidelines, 3-5 and new science concerning their use. 20-23 Given these myriad changes, the current overall prevalence of PET surgery in the US, as well as whether differences by race/ethnicity still persist, is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Racial and Ethnic Differences in Receipt of Pressure Equalization Tubes Among US Children, 2014

Simon

Boss

Zelaya

et al. 2017

Academic Pediatrics

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Objectives Pressure equalization tube (PET) placement (also referred to as tympanostomy tube placement) is among the most common ambulatory surgical procedures performed on U.S. children. Over twenty years ago, differences by race/ethnicity in the national prevalence of having had PETs placed were documented. Whether these differences persist is unknown. Methods We used data from the 2014 National Health Interview Survey to examine the percentage of children 0-17 years of age that have ever undergone PET placement. Unadjusted logistic regression with predictive margins was used to assess the relationship between having received PETs and race/ethnicity, as well as other clinical, socioeconomic, and geographic factors. Multivariable logistic regression was used to determine whether other factors could account for any observed differences by race/ethnicity. Results Overall, 8.9% of children 0 to 17 years of age had undergone PET surgery. By race/ethnicity, 12.6% of non-Hispanic white children received PETs, which was significantly greater than the 4.8% of non-Hispanic black, 4.4% of Hispanic, and 5.6% of non-Hispanic other/multiple race children that had this surgery (p<0.001 for all comparisons). In multivariable analysis, the adjusted prevalence for non-Hispanic white children (10.8%) was greater than for non-Hispanic black (5.4%) and Hispanic (5.8%) children (p<0.001 for both comparisons). Conclusion Nearly 9% of U.S. children have had PETs placed. Non-Hispanic white children still have a greater prevalence of PET placement compared with non-Hispanic black and Hispanic children. These differences could not be fully explained by other demographic, clinical, socioeconomic, or geographic differences between racial/ethnic groups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Racial and Ethnic Differences in Receipt of Pressure Equalization Tubes Among US Children, 2014

Simon

Boss

Zelaya

et al. 2017

Academic Pediatrics

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“…Children with otitis media with effusion or recurrent otitis media are frequently treated with a ventilation tube (VT) placed in the tympanic membrane [10-12]. Little research has been done on the follow-up care after this kind of surgery.…”

Section: Introductionmentioning

confidence: 99%

Implementing guidelines for follow-up after surgery with ventilation tube in the tympanic membrane in Norway: a retrospective study

Austad

Hetlevik²,

Bugten

et al. 2013

BMC Ear Nose Throat Disord

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BackgroundWhen clinical guidelines are being changed a strategy is required for implementation. St. Olavs University Hospital in Norway modified their guidelines for the follow-up care of children after insertion of ventilation tubes (VT) in the tympanic membrane, transferring the controls of the healthiest children to General Practitioners (GPs). This study evaluates the implementation process in the hospital and in general practice by exploring two issues: 1) Whether the hospital discharged the patients they were supposed to and 2) whether the children consulted a GP for follow-up care.MethodsA retrospective observational study was performed at St. Olavs University Hospital, Norway and general practice in Mid-Norway. Children under the age of 18 who underwent insertion of VT between Nov 1st 2007 and Dec 31st 2008 (n = 136) were included. Degree of guideline adherence at the hospital and in general practice was measured.ResultsThe hospital adhered to the guidelines in two-thirds (68.5%) of the patients, planning more patients for follow-up by their GP than recommended in the guidelines (25.8% vs. 12.4%). All except one contacted their GP for control. In total 60% were referred back to specialist health services within two years.ConclusionsThe methods for guideline implementation were successful in securing consultations for follow-up care in general practice. Lack of guideline adherence in the hospital can partly be explained by the lack of quality of the guideline. Further studies are needed to evaluate the quality of controls done by the GPs in order to consider implications for follow-up after VT surgery.

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“…A randomized controlled trial concluded no long term beneficial effects of ventilation tubes on language, speech or cognitive development [33–35], though children with middle ear effusion and a delayed speech development might benefit from VT insertion [32,36–38]. Frequent infections and sleep problems because of otitis media may result in reduced quality of life for the child and the whole family, but the effect of VT on this is ambiguous [39,40]. …”

Section: Discussionmentioning

confidence: 99%

Incidence and Determinants of Ventilation Tubes in Denmark

et al. 2016

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Background and objectivesMany children are treated for recurrent acute otitis media and middle ear effusion with ventilation tubes (VT). The objectives are to describe the incidence of VT in Denmark during 1997–2011 from national register data, furthermore, to analyze the determinants for VT in the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) birth cohort.MethodsThe incidence of VT in all children under 16 years from 1997–2011 were calculated in the Danish national registries. Determinants of VT were studied in the COPSAC2010 birth cohort of 700 children.ResultsNationwide the prevalence of VT was 24% in children aged 0 to 3 three years, with a significant increase over the study period. For all children 0–15 years, the incidence of VT was 35/1,000. In the VT population, 57% was male and 43% females. In the COPSAC2010 birth cohort, the prevalence of VT during the first 3 years of life was 29%. Determinants of VT were: maternal history of middle ear disease; aHR 2.07, 95% CI [1.45–2.96] and siblings history of middle ear disease; aHR 3.02, [2.11–4.32]. Paternal history of middle ear disease, presence of older siblings in the home and diagnosis of persistent wheeze were significant in the univariate analysis but the association did not persist after adjustment.ConclusionThe incidence of VT is still increasing in the youngest age group in Denmark, demonstrating the highest incidence recorded in the world. Family history of middle ear disease and older siblings are the main determinants for VT.

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Ventilation Tube Treatment

Cited by 110 publications

References 87 publications

Racial and Ethnic Differences in Receipt of Pressure Equalization Tubes Among US Children, 2014

Racial and Ethnic Differences in Receipt of Pressure Equalization Tubes Among US Children, 2014

Implementing guidelines for follow-up after surgery with ventilation tube in the tympanic membrane in Norway: a retrospective study

Incidence and Determinants of Ventilation Tubes in Denmark

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