Author(s)
Akshay Prabhakar, BSA
Romaine Johnson, MD
Affiliation(s)
University of Texas Southwestern Medical Center;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to acknowledge the latest "strong recommendation" addition to tympanostomy tube guidelines, recognize the current rates of followup within 3 months, and consider social and informational factors that may influence adherence to initial followup visits.
Objectives: 1) To quantify the percentage of pediatric patients following up within three months after tympanostomy tube insertion; and 2) to explore followup behaviors and patient characteristics influencing the likelihood of first followup within three months.
Study Design: Retrospective cohort study.
Methods: Tympanostomy tube insertions performed between 15 physicians at a pediatric tertiary care hospital from 2021 to 2023 for children aged 0 to 18 years were analyzed based on patient demographics, signs and symptoms at preoperative clinic visit, and date and complications at postoperative followup visits to the surgeon. The first followup date since the procedure was measured and those that visited their otolaryngologist within the three months of the tympanostomy tube insertion were considered positive for the new guidelines and the patients whose first followup was over three months since the surgery were considered negative.
Results: Of the 200 pediatric subjects included, 79 (39.5%) were seen within three months of the tympanostomy tube insertion by the otolaryngologist who performed the patient's surgery. Notable patient factors included Spanish speaking patients with a 37.50% rate of following up within three months (TMFU) and patients with otitis media with effusion (OME) for over 3 months prior to procedure had a 45.38% TMFU. Also, OME resolved at a higher rate in patients whose first followup was within 3 months.
Conclusions: The current rate of pediatric patients following up within three months of tympanostomy tube insertion is low despite literature supporting the benefits of timely followup after surgery. Further research is needed to determine whether surgeon informational gaps or patient social and logistical factors drive this low rate.