A 14-year prospective follow-up study of children treated early in life with tympanostomy tubes: Part 2: Hearing outcomes.

OBJECTIVE To determine hearing outcomes in young children receiving early and repeated tympanostomy tube insertion for recurrent acute otitis media or otitis media with effusion. DESIGN Prospective 14-year follow-up. SETTING Central Hospital of Central Finland, a tertiary care hospital. Patients Three hundred five consecutive infants and young children with otitis media received initial tympanostomy tube insertion at the age of 5 to 16 months. The final study group comprised 237 patients (77.7%) attending the 14-year checkups. MAIN OUTCOME MEASURES At the 14-year checkups, children received clinical examinations and audiometric testing for the determination of bone and air conduction pure-tone thresholds. RESULTS The mean pure-tone average of 177 healed ears was 4.3 dB. The mean pure-tone average of all ears was 5.8 dB, with significantly poorer results in ears with abnormal outcomes such as grade II or higher pars tensa retraction, otitis media with effusion, and tympanic membrane perforation. Thirteen (5.5%) of 237 ears had a hearing level worse than 15 dB, and the better ear hearing level was poorer than 15 dB in 3 patients. CONCLUSIONS The hearing level of healed ears was comparable to that of age-matched normal ears. Hearing losses were infrequent, of slight grade, and, when present, almost exclusively conductive and related to unsuccessful otological outcomes. From the hearing point of view, repeated tympanostomy tube insertion for recurrent acute otitis media or otitis media with effusion early in life is a safe treatment.