The effect of ventilation tube insertion on quality of life in children with persistent otitis media with effusion
Sanyaolu LN., Cannings-John R., Butler CC., Francis NA.
© 2019 John Wiley & Sons Ltd Objectives: To determine the effect of ventilation tube (VT) surgery on quality of life (QoL) in children with persistent otitis media with effusion (OME). Design: Secondary analysis of trial data (oral steroids versus placebo for persistent OME), comparing QoL by history of VT surgery performed between 5 weeks and 12 months post-randomisation. Multilevel regression models were used to identify the association between VT surgery and QoL scores at 12 months, controlling for pre-exposure risk factors associated with surgery, including pre-surgery hearing level. Setting: Ear, nose and throat (ENT), paediatric audiology and audiovestibular medicine (AVM) departments in Wales and England. Participants: A total of 327 children aged 2-8 years with OME symptoms for at least three months and audiometry-proven bilateral hearing loss with VT surgery status. Main outcome measures: Otitis Media questionnaire (OM8-30) and Paediatric Quality of Life Inventory (PedsQL) total and subscale scores, and the Health Utilities Index Mark 3 (HUI3) at 12 months post-randomisation. Results: Participants who had VT surgery had no significant difference in OM8-30, PedsQL or HUI total scores. OM8-30 hearing difficulty (HD) subscale scores at 12 months were better in those who had VT surgery (adjusted mean difference (aMD) = −0.46 (95% confidence interval: −0.69 to −0.23), P <.001), and this varied by when the surgery occurred (aMD for surgery between 5 weeks and 6 months = −0.4 [−0.67 to −0.13], P =.004 and between 6 and 12 months = −0.54, [−0.87 to −0.22], P =.001). Conclusion: Ventilation tube surgery was associated with an improvement in HD-related functional health status but no change in overall QoL.