Assessing the Role of Nasal Irrigation in Chronic Otorrhea in Children With Tympanostomy Tubes.

IMPORTANCE

Nasal irrigation (NI) is effective in the treatment of sinonasal disease; however, its efficacy in treating otologic conditions is undetermined. Chronic otorrhea (CO) is an important complication in children with tympanostomy tubes (TT), requiring additional treatment.

OBJECTIVE

Determine potential factors of NI that put children with TT at risk of developing CO.

STUDY

DESIGN

Case-control study.

SETTING

Single tertiary level of care pediatric hospital.

PARTICIPANTS

Consecutive patients under the age of 18 with bilateral TT presenting between June and September 2023 were selected.

INTERVENTION: All patients in this study used NI.

MAIN OUTCOME MEASURES: The main outcome was the development of CO, defined as 10 or more consecutive days of ear drainage despite proper treatment.

RESULTS

Twenty consecutive patients with CO were recruited and compared to 100 consecutive controls without CO. The mean age was similar, with 22.9 ± 18.4 months for the CO group and 25.2 ± 16.4 months for the control group (P = .59). An immediate discharge occurred more frequently in the CO group (80%) than in the control group (46%, P = .005; OR: 4.70; 95% CI: 1.5-13.5). A fast rate of administration of NI was more prevalent in the CO group (75%) compared to the control group (51%, P = .049; OR: 2.88; 95% CI: 1.0-7.6). TT insertion under local anesthesia occurred more frequently in the CO group (45%) than in the control group (22%, P = .03; OR: 2.9; 95% CI: 1.1-7.4). No statistical difference was found between groups in the frequency and volume of NI. No patients with CO used a small volume of NI (≤5 mL).

CONCLUSION AND RELEVANCE: A fast rate of administration of NI was correlated with an increased risk of CO. Patients should be encouraged to apply gentle pressure as it could potentially prevent this complication.