Single Visit Surgery an Appealing Option for Tympanostomy Tube Placement in Children with Recurrent Acute Otitis Media

by Linda Kossoff •

What can be learned from implementing a single visit surgery (SVS) program for children with recurrent acute otitis media (AOM) undergoing tympanostomy tube (TT) placement the same day as their otolaryngology surgical consultation?

BOTTOM LINE

SVS for TT placement can be a successful alternative care model for management of children with AOM, offering convenience and cost savings to family members, and marketing efforts promoting this option are effective.

BACKGROUND: SVS is a healthcare delivery model associated with high patient satisfaction and cost savings to caregivers. In the U.S. annually, 667,000 children younger than 15 years undergo TT placement. There is potential for large numbers of pediatric patients with recurrent AOM benefitting from this streamlined, patient-centric model.

STUDY DESIGN: Retrospective cohort analysis.

SETTING: Division of Pediatric Otolaryngology–Head and Neck Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Ill.

SYNOPSIS: Researchers analyzed the health records of patients with recurrent AOM participating in their institution’s SVS program from inception on March 1, 2014, to April 30, 2020. During the program, a total of 224 children had TT placed through SVS for AOM management. A time frame analysis included time between initial patient phone assessment for candidacy and SVS date. Comparison with a best-matched non-SVS group was completed. To determine the effect of community awareness tactics on program growth, volume trends following a direct-to-consumer marketing campaign were analyzed. Results showed the average duration between initial contact and SVS date as 16.5 days in the SVS group and 23 days in the non-SVS group. Increases in SVS program patient volume were seen following radio advertisement campaigns and after implementation of a scheduling algorithm for children with recurrent AOM. Cost savings opportunities to parents included fewer workdays lost and a reduction of AOM episodes with more time-efficient intervention. Study limitations were the study’s retrospective nature and the reliance of AOM diagnoses on the clinical acumen of the referring provider.

CITATION: Billings KR, Hajduk J, Thompson DM. Single visit evaluation and tympanostomy tube placement for the treatment of acute otitis media in children. Laryngoscope. 2021;131:2823-2829.