Ventilation Tubes in Otitis Media May Lower Quality of Life

What is the impact of otitis media on patient and parental quality of life?

Background: Otitis media is one of the most common, if not the most common, medical problem of childhood. Otitis media has an impact on each afflicted individual, but the disease also carries a huge economic and social burden for society. Learning more about the consequences for the individual may help decision-making in management of the disorder, which in turn may help to reduce the economic and social burden for society.

Study design: Multi-institutional prospective cross-sectional study.

Setting: Otolaryngology practice, family practice, and pediatric clinics; primary care and tertiary referral centers.

Synopsis: With a single inclusion criteria of children aged six to 24 months presenting with a complaint of otitis media, data on otitis media severity, quality of life impact on the child, and quality of life impact on the caregiver(s) was collected through a series of validated surveys. For the children, more severe otitis media survey results were correlated with lower (poorer) quality of life scores. Comparisons were also made between similarly aged healthy children, children with recurrent otitis media, children with a recommendation for ventilation tubes, and children with ventilations tubes. There was a correlation with both the severity of otitis media scores and poor quality of life scores for child who received a recommendation for ventilation tubes. Children with ventilation tubes had better quality of life scores, but their scores did not match those of well children.

For caregivers, the quality of life scores were best when the child did not receive a recommendation for ventilation tubes, followed closely by the cohort whose children had received ventilation tubes. The worst quality of life scores were in the group for whose children were recommended ventilation tubes. A limitation of the studies is that there is no longitudinal data to assess the impact of intervention on the outcome measures.

Bottom line: Current recommendations and guidelines for ventilation tube placement in children aged six to 24 months follow specific objective measures. Data such as presented in these manuscripts may help assess additional subjective measures, which could help guide decisions regarding recommendations for or against ventilation tube placement for management of otitis media.

Citations: Grindler DJ, Blank SJ, Schulz KA, Witsell DL, Lieu JE. Impact of otitis media severity on children’s quality of life. Otolaryngol Head Neck Surg. 2014;151:333-340; Blank SJ, Grindler DJ, Schulz KA, Witsell DL, Lieu JE. Caregiver quality of life is related to severity of otitis media in children. Otolaryngol Head Neck Surg. 2014;151:348-353.

—Reviewed by George Hashisaki, MD