Intraoperative and postoperative findings in children with myringotomy tubes (MT) undergoing cochlear implantation (CI)

Abstract

Objective

To evaluate and compare children undergoing cochlear implantation (CI) with myringotomy tubes (MT) placed preoperatively or intraoperatively to those without MT .

Methods

This was a retrospective review of pediatric patients undergoing CI between 2015 to 2020 at a tertiary care pediatric hospital. CI patients with and without MT were reviewed for the following outcomes: intraoperative findings, intraoperative and postoperative complications, and surgical time. Descriptive and bivariable statistical analysis was performed.

Results

192 cochlear implant surgeries were included: 116 without MT tubes and 76 with a history of MT. Twenty-six patients had MT present at the time of CI surgery. No statistical difference existed between patients with MT (CI + MT group) and those without MT (CI – MT group) with regard to intraoperative complications (P = 0.760) and intraoperative findings (P = 0.545). MT association with total post-operative complications (GEE) showed no statistical significance (OR 2.45, 95% CI 0.83–7.22, P-value 0.105). CI + MT patients were significantly more likely to have inflamed middle ear mucosa at time of surgery (P = 0.003). CI + MT patients did not have a longer length of surgery compared to the CI – MT group (3.47 h vs 3.3 h, respectively, P = 0.342).

Conclusion

Our data confirms it is safe to perform CI in ears with myringotomy tubes, although the surgeon should be aware of possibly encountering increased middle ear inflammation during the surgery.

Keywords:

• Paediatric cochlear implant
• myringotomy tube
• middle ear inflammation

Additional information

Notes on contributors

Alexa Marie Robbins

Alexa Robbins, MD, is an Otolaryngology-Head and Neck Surgery resident at Emory University. She completed her medical degree at the University of Arkansas for Medical Sciences.

William Larsen Vaughn

William Larsen Vaughn, MD, is an Internal Medicine resident at Wellstar Kennestone Medical Center in Marietta, GA, and completed his medical degree at Mercer University School of Medicine.

Courtney B. Voyles

Courtney B Voyles, BS, is a medical student at Ross University School of Medicine. She completed her Bachelor of Science degree in biological engineering at the University of Florida prior to this.

Ching Siong Tey

Ching Siong Tey, BS, is an ACRP-certified clinical research coordinator with 11 years of clinical research experience. He is serving as a clinical research contact for the ENT division at Emory University and Children’s Healthcare of Atlanta. His expertise includes research ethics, regulatory and compliance, study design and research operation.

Yijin Xiang

Yijin Xiang, MPH, is the Biostatistician of Pediatric Biostatistics Core. She joined the core in July 2020 after graduating from Rollins School of Public Health at Emory University. Yijin has expertise and experience in conducting longitudinal data analysis, clustered data analysis, and Bioinformatics data analysis.

Chao Zhang

Chao Zhang, PhD, is a Ph.D. statistician at Biostatistics Core at the Department of Pediatrics of Emory University. He got a Ph.D. in health statistics from Southern Medical University in China, a master's degree in mathematical statistics and MPH certificate from Wayne State University. He published more than 90 peer-reviewed publications associated with biomedical research at the Southern Medical University, Wayne State University, University of Michigan, and Emory University. His research interests in biostatistics methods include statistical models on survival analysis, longitudinal data analysis, clinical trial, power and sample size estimation, and novel statistical tools such as SAS macros development.

Nandini Govil

Nandini Govil, MD, MPH is an assistant professor in Paediatric Otolaryngology at Emory University and Children’s Hospital of Atlanta. She completed a fellowship in pediatric otolaryngology at the University of Pittsburgh Medical Center/Children’s Hospital of Pittsburgh. Prior to her fellowship, Dr Govil earned a medical degree from New York University School of Medicine, followed by residency training in otolaryngology at the University of Pittsburgh Medical Center. Dr Govil also received her Master of Public Health from the New York University Global Institute of Public Health.