Chronic otitis media requiring ventilation tubes in tracheotomized ventilator dependent children

Abstract

The occurrence of sinusitis and middle ear effusions has frequently been attributed to the obstruction of the sinus ostia and/or eustachian tube. In the intensive care unit setting, edema caused by the irritation from nasogastric, nasotracheal and orotracheal tubes has been associated with this pathology and has been responsible for occult sepsis in this population. Our investigation was performed to determine the risk of chronic otitis media with effusion necessitating myringotomy with tympanostomy tubes among tracheotomized, ventilator dependent children in a consecutive series of children admitted to our recently created stable ventilator unit. We retrospectively reviewed the medical records of all tracheotomized, chronically ventilator dependent children P < 0.01. We conclude chronic otitis media with effusion is a common finding among preschool-aged children who are tracheotomized and ventilator dependent. Routine periodic ENT evaluation may be indicated in all pediatric patients who require chronic mechanical ventilation. In this specific population of children, there may be a subset of patients who would benefit from prophylactic antibiotic therapy or tympanostomy tube insertion during the duration of positive pressure ventilation. Further prospective study is warranted.