Effectiveness of Surgical Approach of Insertion Ventilation Tubes (Tympanostomy) and Adenoidectomy in Comparison with Non-Surgical Approach (Watchful Waiting Approach) in Children at the Age between 1 and 6 and Who Suffer from Otitis Media with Effusion (OME) in 12-Month Period of Observation—The Retrospective Analysis
Abstract
:1. Introduction
Objective
2. Materials and Methods
3. Results
Evaluation of Pharmacological Treatment in the Non-Surgical Group
4. Discussion
5. Conclusions
- The surgery limits the recurrences of AOM during the following 12 months. Our data show that the average child from the control group (the non-surgical group) required approximately five-times more visits in the ensuing 12 months than the average child from the surgical group. The risk ratio (RR) of recurrence of AOM in the surgery group in comparison with the non-surgery group was equal to 0.21.
- The surgery limits the prescription of steroids, antibiotics, mucolytics, antibiotics, and other drugs. On average, 1.72 drugs were prescribed at the first visit, 1.52 drugs were prescribed at the first recurrence, 1.55 drugs at the second recurrence, and 2.14 drugs at the third recurrence in this group. The reduction of prescribed antibiotics is important due to the rising resistance of bacteria to antibiotics.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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n | Min | Max | M | SD | |
---|---|---|---|---|---|
Surgical group | 422 | 1.91 | 6.00 | 4.05 | 0.95 |
Non-surgical group | 50 | 1.86 | 5.95 | 3.65 | 1.02 |
Male | Female | Total | |
---|---|---|---|
Surgical group | 250 (59.2) | 172 (40.8) | 422 (100.0) |
Non-surgical group | 26 (52.0) | 24 (48.0) | 50 (100.0) |
1–2 Years | 2–3 Years | 3–4 Years | 4–5 Years | 5–6 Years | Total | |
---|---|---|---|---|---|---|
Surgical group | 1 (0.2) | 61 (14.5) | 154 (36.5) | 120 (28.4) | 86 (20.4) | 422 (100.0) |
Non-surgical group | 3 (6.0) | 8 (16.0) | 23 (46.0) | 11 (22.0) | 5 (10.0) | 50 (100.0) |
No | Yes | Total | |
---|---|---|---|
Surgical group | 233 (55.2) | 189 (44.8) | 422 (100.0) |
Non-surgical group | 28 (56.0) | 22 (44.0) | 50 (100.0) |
No | Yes | Total | |
---|---|---|---|
Surgical group | 367 (87.0) | 55 (13.0) | 422 (100.0) |
Non-surgical group | 16 (32.0) | 34 (68.0) | 50 (100.0) |
Number of ENT Consultations | Number of Patients | Percentage |
---|---|---|
1 | 312 | 73.9 |
2 | 63 | 14.9 |
3 | 29 | 6.9 |
4 | 8 | 1.9 |
5 | 5 | 1.2 |
6 | 2 | 0.5 |
7 | 1 | 0.2 |
8 | 1 | 0.2 |
9 | 1 | 0.2 |
Total | 422 | 100.0 |
Number of ENT Consultations | Number of Patients | Percentage | Descriptive Statistics | |
---|---|---|---|---|
Surgical group | 0 | 312 | 73.9 | Min = 0; Max = 3; M = 0.22; SD = 0.55 |
1 | 63 | 14.9 | ||
2 | 29 | 6.9 | ||
3 | 8 | 1.9 | ||
Non-surgical group | 0 | 5 | 1.2 | Min = 0; Max = 3; M = 1.16; SD = 0.91 |
1 | 2 | 0.5 | ||
2 | 1 | 0.2 | ||
3 | 1 | 0.2 |
n | Min | Max | M | SD | Me | |
---|---|---|---|---|---|---|
Surgical group | 422 | 20 | 365 | 328.03 | 91.44 | 365 |
Non-surgical group | 50 | 13 | 365 | 169.24 | 127.31 | 136.50 |
Relative Risk | 0.2103 |
---|---|
95% CI | 0.1632 to 0.2710 |
Z statistic | 12.060; p < 0.001 |
NNT (Benefit) | 1.583 |
95% CI | 1.347 (Benefit) to 1.918 (Benefit) |
How Many Different Pharmaceutical Groups of Drugs Were Prescribed? | 1st Visit (Time of Diagnosis of OME) | 1st Recurrence during 12-Month Observation Period | 2nd Recurrence during 12-Month Observation Period | 3rd Recurrence during 12-Month Observation Period |
---|---|---|---|---|
0 | 4 | 3 | 2 | - |
1 | 20 | 18 | 4 | 1 |
2 | 15 | 15 | 2 | 4 |
3 | 8 | 3 | 3 | 2 |
4 | 3 | 1 | - | - |
Antibiotics | Steroids | Antihistamines | Mucolytics | Other | |||||
---|---|---|---|---|---|---|---|---|---|
Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity |
Amoxiciline + clavulonic acid | 6 | Fluticasone furoate | 8 | Desloratadine | 2 | Ambroksol hydrochloride | 10 | Oxymetazolini | 2 |
Neomycin + gramicidin + fludrocortisone | 1 | Fluticasone propionate | 8 | Levocetirizine | 4 | Bromhexine hydrochloride | 2 | Xylometazoline Hydrochloride | 3 |
Cefuroxime axetil | 2 | Mometasone furoate | 21 | Cetirizine | 3 | Carbocisteine | 2 | Herbal medicines | 2 |
Tobramycin | 2 | Budesonide | 3 | Trimethoprim/sulfamethoxazole | 1 | ||||
Total: | 11 | 40 | 9 | 14 | 8 |
Antibiotics | Steroids | Antihistamines | Mucolytics | Other | |||||
---|---|---|---|---|---|---|---|---|---|
Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity |
Amoxicilin + clavulonic acid | 8 | Fluticasone furoate | 5 | Desloratadine | 4 | Ambroxol hydrochloride | 5 | Oxymetazolini hydrochloridum | 7 |
Amoxicillin | 1 | Fluticasone propionate | 3 | Levocetirizine | 2 | Bromhexine hydrochloriudum | 1 | Xylometazoline Hydrochloride | 1 |
Cefuroxime axetil | 2 | Mometasone furoate | 13 | Carbocisteine | 1 | Hydrocortisone + Oxytetracycline hydrochloridum + Polymyxin B | 1 | ||
Tobramycin | 1 | Budesonide | 2 | Acetylcysteine | 1 | ||||
Neomycin + gramicidin + fludrocortisone | 1 | ||||||||
Azithromycin | 1 | ||||||||
Total: | 14 | 23 | 6 | 8 | 9 |
Antibiotics | Steroids | Antihistamines | Mucolytics | Other | |||||
---|---|---|---|---|---|---|---|---|---|
Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity |
Amoxicilin + clavulonic acid | 2 | Fluticasone furoate | 1 | Desloratadine | 1 | Xylometazoline Hydrochloride | 1 | ||
Cefuroxime axetil | 2 | Fluticasone propionate | 1 | Levocetirizine | 1 | Hydrocortisone + Oxytetracycline hydrochloridum + Polymyxin B | 1 | ||
Mometasone furoate | 6 | ||||||||
Budesonide | 1 | ||||||||
Total: | 4 | 9 | 2 | 0 | 2 |
Antibiotics | Steroids | Antihistamines | Mucolytics | Other | |||||
---|---|---|---|---|---|---|---|---|---|
Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity | Name of Substance | Quantity |
Amoxicilin + clavulonic acid | 1 | Fluticasone furoate | 1 | Oxymetazolini hydrochloridum | 2 | ||||
Cefuroxim axetil | 2 | Mometasone furoate | 5 | ||||||
Azithromycin | 1 | Budesonide | 1 | ||||||
Neomycin + gramicidin + fludrocortisone | 1 | ||||||||
Total: | 5 | 7 | 0 | 0 | 2 |
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Skarzynska, M.B.; Gos, E.; Czajka, N.; Sanfis, M.D.; Skarzynski, P.H. Effectiveness of Surgical Approach of Insertion Ventilation Tubes (Tympanostomy) and Adenoidectomy in Comparison with Non-Surgical Approach (Watchful Waiting Approach) in Children at the Age between 1 and 6 and Who Suffer from Otitis Media with Effusion (OME) in 12-Month Period of Observation—The Retrospective Analysis. Int. J. Environ. Res. Public Health 2021, 18, 12502. https://doi.org/10.3390/ijerph182312502
Skarzynska MB, Gos E, Czajka N, Sanfis MD, Skarzynski PH. Effectiveness of Surgical Approach of Insertion Ventilation Tubes (Tympanostomy) and Adenoidectomy in Comparison with Non-Surgical Approach (Watchful Waiting Approach) in Children at the Age between 1 and 6 and Who Suffer from Otitis Media with Effusion (OME) in 12-Month Period of Observation—The Retrospective Analysis. International Journal of Environmental Research and Public Health. 2021; 18(23):12502. https://doi.org/10.3390/ijerph182312502
Chicago/Turabian StyleSkarzynska, Magdalena Beata, Elżbieta Gos, Natalia Czajka, Milaine Dominici Sanfis, and Piotr Henryk Skarzynski. 2021. "Effectiveness of Surgical Approach of Insertion Ventilation Tubes (Tympanostomy) and Adenoidectomy in Comparison with Non-Surgical Approach (Watchful Waiting Approach) in Children at the Age between 1 and 6 and Who Suffer from Otitis Media with Effusion (OME) in 12-Month Period of Observation—The Retrospective Analysis" International Journal of Environmental Research and Public Health 18, no. 23: 12502. https://doi.org/10.3390/ijerph182312502