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Discussion: Incidence of otorrhea in children with ventilating tubes.

Dr. Bluestone: The prevalence of otorrhea among children with tympanostomy tubes is quite high. Data from three clinical trials in the 1990s revealed a prevalence rate of about 50% among children who had ventilating tubes and whose ears were examined once a month for 2 or 3 years. Dr. Paradise: We reported even higher numbers in an abstract in Pediatric Research in 1997, although the data were all from children younger than 3 years old and all had tubes placed principally because of persistent middle ear effusion rather than recurrent acute otitis media. But over 80% of those children followed for at least 18 months sooner or later developed at least one episode of otorrhea. Dr. Pransky: Those numbers are surprising. The literature of the last decade puts the prevalence of otorrhea in children with tympanostomy tubes at 5 to 38%, which is low compared with the numbers you are describing. 3 Dr. Bluestone: The different prevalence rates are a result of the design of the study. The earlier reports often described small, less rigid studies or anecdotal reports. Dr. Paradise’s study involved 6000 children who were systematically evaluated at regular intervals. These types of data give more accurate assessment of the true numbers. Dr. Gates: We observed a slightly lower rate among our population of older kids with secretory otitis (11 to 29%). The rate was least in the adenoidectomy cases. We did not follow them as closely as you describe; however, we saw them every 6 weeks. But the bottom line is that otorrhea is a very common problem among children who have tympanostomy tubes in place, particularly younger children.