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Increased eustachian tube dysfunction in infants with obstructive sleep apnea

Authors

  • Jacob G. Robison MD, PhD,

    1. Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh
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  • Caleb Wilson BS,

    1. the University of Pittsburgh College of Medicine, Pittsburgh
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  • Todd D. Otteson MD, MPH,

    1. Department of Pediatric OtolaryngologyChildren's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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  • Sangeeta S. Chakravorty MD,

    1. Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh; Department of Pediatrics, Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
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  • Deepak K. Mehta MD

    Corresponding author
    1. Department of Pediatric OtolaryngologyChildren's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
    • Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, 4401 Penn Avenue, Seventh Floor, Faculty Pavillion, Pittsburgh, PA 15224
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

  • The abstract was presented as a podium presentation at the Society for Ear, Nose and Throat Advances in Children (SENTAC) Annual Meeting, Kansas City, Missouri, U.S.A., December 1–4, 2011.

Abstract

Objectives/Hypothesis:

To investigate the prevalence of eustachian tube dysfunction (ETD) in infants with obstructive sleep apnea (OSA).

Study Design:

Retrospective medical record review of infants (3–24 months old) diagnosed with OSA and ETD.

Methods:

There were 94 infants diagnosed with OSA by polysomnography and ETD as determined by performance of myringotomy and ventilation tube placement (MT). The main outcome measures were demographic data, apnea-hypopnea index, dates and number of MTs, interventions for treatment of OSA, and medical comorbidities.

Results:

Of 295 infants diagnosed with OSA, 94 (31.9%) had concomitant ETD. A total of 135 MT procedures were performed, with 30 (31.9%) patients undergoing two or more procedures. The average age of first MT was 16.3 months for those undergoing MT only once, and 11.1 months for those undergoing at least two MT procedures. There was no difference in average age of first MT when analyzed by OSA severity (15.6 months, 14.2 months, and 14.6 months for mild, moderate, and severe OSA, respectively). The first MT procedure was performed before or concurrent with the first treatment for OSA in 75 (80%) patients. Of the 137 interventions for treatment of OSA, 10 (45.5%) nonsurgical and 75 (65.2%) surgical interventions did not require further MT procedures afterward.

Conclusions:

The ETD prevalence of 32% in infants with OSA is increased compared to the general pediatric prevalence of 4% to 7%. Patients presenting for evaluation of OSA should also be evaluated for ETD. Surgical interventions for treatment of OSA led to decreased need for further MT procedures.

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