Parent-Reported Otorrhea in Children with Tympanostomy Tubes: Incidence and Predictors
Parent-Reported Otorrhea in Children with Tympanostomy Tubes: Incidence and Predictors
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DOI：
10.1371/journal.pone.0069062
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发表时间：
2013-07-12
期刊：
影响因子：
3.7
通讯作者：
Schilder, Anne G. M.
中科院分区：
文献类型：
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作者：
van Dongen, Thijs M. A.;van der Heijden, Geert J. M. G.;Schilder, Anne G. M.
目的：虽然在鼓膜置管儿童中常见，但目前鼓膜置管耳漏（TTO）的发病率尚不确定。当中耳液体通过管道排出时，TTO 通常是中耳炎的征兆。因此，中耳炎的预测因子被认为对 TTO 的发生具有预测价值。目的：确定 TTO 的发生率及其预测因子。方法：我们进行了一项队列研究，使用家长网络调查问卷回顾性收集 10 岁以下接受鼓膜置管的儿童的 TTO 发作及其潜在预测因子的数据。结果：在纳入分析的 1,184 名儿童中（自置管以来的总持续时间为 768人年（平均每个孩子 7.8 个月），616 名儿童 (52%) 经历过一次或多次 TTO。 137 名儿童 (12%) 在置管的日历月内接受了 TTO。 597 名 (50%) 儿童有过一次或多次急性 TTO 发作（持续时间 = 4%）和一次或多次慢性 TTO 发作（持续时间 4 周）。 146 名儿童 (12%) 经历过反复 TTO 发作。考虑到插管后的时间，67% 的儿童在插管后一年内出现一次或多次 TTO 发作。年龄小、复发性急性中耳炎是置管指征、近期复发性上呼吸道感染病史以及年长兄弟姐妹的存在与未来 TTO 的发生独立相关，因此可以被视为 TTO 的预测因素。 结论：我们的调查证实，耳漏是鼓膜造口管儿童的常见后遗症，可以通过年龄、病史和年长兄弟姐妹的存在来预测耳漏的发生。
Purpose: Although common in children with tympanostomy tubes, the current incidence of tympanostomy tube otorrhea (TTO) is uncertain. TTO is generally a sign of otitis media, when middle ear fluid drains through the tube. Predictors for otitis media are therefore suggested to have predictive value for the occurrence of TTO.Objective: To determine the incidence of TTO and its predictors.Methods: We performed a cohort study, using a parental web-based questionnaire to retrospectively collect data on TTO episodes and its potential predictors from children younger than 10 years of age with tympanostomy tubes.Results: Of the 1,184 children included in analyses (total duration of time since tube placement was 768 person years with a mean of 7.8 months per child), 616 children (52%) experienced one or more episodes of TTO. 137 children (12%) had TTO within the calendar month of tube placement. 597 (50%) children had one or more acute TTO episodes (duration = 4%) one or more chronic TTO episodes (duration $ 4 weeks). 146 children (12%) experienced recurrent TTO episodes. Accounting for time since tube placement, 67% of children developed one or more TTO episodes in the year following tube placement. Young age, recurrent acute otitis media being the indication for tube placement, a recent history of recurrent upper respiratory tract infections and the presence of older siblings were independently associated with the future occurrence of TTO, and can therefore be seen as predictors for TTO.Conclusions: Our survey confirms that otorrhea is a common sequela in children with tympanostomy tubes, which occurrence can be predicted by age, medical history and presence of older siblings.