Long-term quality of life outcomes after tympanostomy tube by surgical indication.

OBJECTIVE

To compare longitudinal quality of life (QOL) outcomes among pediatric patients undergoing tympanostomy tube placement (TTP) for recurrent acute otitis media alone (rAOM), both rAOM and other indication(s), and other indication(s) alone, using the Otitis Media-6 (OM-6) questionnaire.

METHODS

We conducted a retrospective cohort study of children aged 0-6 years who underwent TTP at a tertiary pediatric center between January 2020 and August 2024. Inclusion required completion of both preoperative and postoperative OM-6 surveys. The primary outcome was change in total OM-6 score over time, assessed at 0-2, 2-6, 6-12, 12-18, and 18-24 months postoperatively. Analysis used inverse probability weighting and linear mixed-effects regression (LMER) adjusted for sociodemographic and clinical covariates.

RESULTS

Among 7800 subjects, 4511 (57.8%) underwent surgery for rAOM alone, 2462 (31.6%) for mixed indications, and 827 (10.6%) for other indications alone. At baseline, children in the rAOM and mixed groups had significantly worse QOL than those with other indications alone. Across all follow-up intervals, children with rAOM or mixed indications demonstrated significantly greater improvement in total OM-6 scores compared with other-indication alone. Domain-specific analyses showed greater improvement in caregiver concerns, activity limitations, emotional distress, and physical suffering among children with rAOM, whereas hearing-related improvement was greatest in the other-indication groups.

CONCLUSION

TTP resulted in sustained long-term QOL improvements across all indication groups. Despite worse baseline scores in the rAOM group, this group had proportionally greater improvement in total OM-6 scores, leading to similar long-term total OM-6 scores across indications.