Quality of life in Swedish children receiving grommets – An analysis of pre- and postoperative results based on a national quality register

Publication date: Available online 6 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Job van Brink, Marie Gisselsson-Solen

Abstract

Background

Otitis media with effusion (OME) and recurrent otitis media (rAOM) are two common diagnoses in childhood, both of which are treated with grommets, or ventilation tubes. It is known that affected children have a worse quality of life (QoL), and various questionnaires have been used to evaluate this. The national Swedish quality register for grommet insertions contains some QoL questions that have hitherto never been analysed.

Methods

Data from 2010 to 2016 was extracted from the register and analysed with regards to QoL questions, reasons for surgery, hearing levels and number of AOM episodes.

Results

Preoperative QoL data was available for 3835 children. Before surgery, most parents felt that the QoL of their children was negatively affected by the ear disease. Parents of children with OME were more likely to suspect that their child had a hearing loss (ORs 10.1 and 28.2 for suspecting a mild and severe hearing loss, respectively), but less likely to find that the ear disease affected the child's general wellbeing than did parents of children with rAOM (ORs 0.54 and 0.33 for somewhat and much affected, respectively). Many children underwent surgery despite not fulfilling the criteria for surgery as stipulated in the national guidelines. Those who did fulfil criteria, however, had a more severely affected QoL. A significant improvement was seen in individual QoL scores after surgery (p < 0.001). The degree of postoperative improvement in pure tone average correlated with the improvement in QoL (p < 0.001).

Conclusion

This is the first time that the QoL aspect has been analysed in the Swedish grommet register. Though the validity of the questions has not been proven, they provide valuable information. The relevance of the surgical criteria in national guidelines is illustrated by their correlation with the QoL questions, particularly for OME, and the postoperative improvement in QoL suggests parents find that their children benefit from surgery.

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