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

Abstract

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.