Middle Ear Effusion Up for Children With Tracheostomy on Ventilator

Mechanical ventilation increases risk for development of middle ear effusion in tracheostomy-dependent children

THURSDAY, April 7, 2022 (HealthDay News) — For children with a tracheostomy, the likelihood of developing middle ear effusion (MEE) is increased for those requiring mechanical ventilation, according to a study published in the April issue of the International Journal of Pediatric Otorhinolaryngology.

Erin M. Wynings, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues conducted a prospective longitudinal study involving children younger than 2 years of age with a tracheostomy placed at a tertiary care children’s hospital between 2015 and 2020 with at least one tympanometry exam; data were included for 94 children, with a mean age of 5.4 months at tracheostomy. The development of MEE, defined as a flat tympanogram with normal external canal volume, was examined.

The researchers found that 192 tympanometry examinations were obtained during a mean follow-up of 18.3 months, with 59 percent obtained while mechanical ventilation was required. Overall, 56.5 percent of the children developed at least one MEE within 24 months after tracheostomy. A total of 74.0 and 31.2 percent of those on and not on mechanical ventilation, respectively, developed MEE (hazard ratio, 2.97). Children on a ventilator did not have persistent MEE on two consecutive exams significantly more often. Ventilator dependence significantly predicted the presence of MEE when controlling for age at exam, craniofacial syndrome, and newborn hearing test results (odds ratio, 2.34).

“Our study suggests we should also be mindful of things that might appear more trivial, like ear effusions, because they can impact communication skills and developmental milestones in a vulnerable population of kids,” a coauthor said in a statement.

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