Caregiver-reported short-term effect and quality of life improvements after tympanostomy tube insertion in children with chronic otitis media with effusion.

BACKGROUND: Chronic otitis media with effusion (COME) is a leading indication for tympanostomy tube insertion (TTI) in young children. While long-term developmental effects of TTI appear limited, short-term outcomes are less well described. OBJECTIVES: To assess caregiver-reported outcomes of TTI in children aged 1-4 years with COME, including reasons for consultation, baseline quality of life (QoL), and perceived changes one month after surgery. METHODS: This prospective study included 60 children with COME recruited from two non-referral ENT clinics in Denmark. Participants were randomized 1:1 to TTI or one-month observation. Controls who still met guideline criteria after one month were offered TTI. Caregivers completed the OM-6 questionnaire and two global QoL numerical rating scales at baseline and one month after TTI. Paired t-tests and Spearman correlations were used. RESULTS: Fifty-four children completed follow-up; 52 underwent TTI. Sleep disturbance was the most frequent caregiver-reported complaint (74%). Mean baseline OM-6 score was 3.16 (SD 1.0); the lowest item score was activity limitation (2.5), the only OM-6 item reflecting sleep. At one month, child QoL improved from 6.2 to 8.5 (Δ2.6; p < 0.0005) and family QoL from 6.7 to 8.1 (Δ1.7; p < 0.0005). OM-6 correlated with child (ρ = -0.56) and family QoL (ρ = -0.55). Caregivers reported improvement in sleep (58%), hearing (60%), and language (72%); overall satisfaction was 96%. CONCLUSION: TTI was associated with significant short-term improvement in child and family QoL. The low OM-6 activity limitation score despite frequent caregiver-reported sleep disturbance suggests otitis media-specific QoL instruments may underrepresent sleep-related morbidity.