• Middle ear fluid common in kids on venti

    From ScienceDaily@1:317/3 to All on Mon Apr 4 22:30:44 2022
    Middle ear fluid common in kids on ventilators

    Date:
    April 4, 2022
    Source:
    UT Southwestern Medical Center
    Summary:
    Babies and toddlers who need a tracheostomy -- a tube surgically
    inserted into their windpipe to help relieve breathing problems --
    are at a high risk of accumulating fluid behind their eardrum when
    on a ventilator.

    That's the conclusion of a new study by head and neck surgeons. This
    buildup of fluid, called a middle ear effusion, can put them at
    risk for ear infections, hearing loss, and delays in speech and
    language development.



    FULL STORY ========================================================================== Babies and toddlers who need a tracheostomy -- a tube surgically
    inserted into their windpipe to help relieve breathing problems --
    are at a high risk of accumulating fluid behind their eardrum when
    on a ventilator. That's the conclusion of a new study, published
    in theInternational Journal of Pediatric Otorhinolaryngology, by UT Southwestern head and neck surgeons. This buildup of fluid, called a
    middle ear effusion, can put them at risk for ear infections, hearing
    loss, and delays in speech and language development.


    ==========================================================================
    "The majority of the time that these children are being cared for, the
    focus is on more pressing lung and heart concerns," said study leader
    Stephen R.

    Chorney, M.D., M.P.H., Assistant Professor of Otolaryngology -- Head
    & Neck Surgery at UTSW and Pediatric Otolaryngologist at Children's
    Health. "But our study suggests we should also be mindful of things
    that might appear more trivial, like ear effusions, because they can
    impact communication skills and developmental milestones in a vulnerable population of kids." Many young children who require a tracheostomy
    were born prematurely with underdeveloped lungs or narrow airways. In
    these cases, doctors may attach a mechanical ventilator -- a form of
    life support to help a child breathe -- to the tracheostomy tube.

    Middle ear effusion (MEE) is a common problem for all young
    children. Nearly one in ten kids have ear tubes placed to help clear
    this fluid, treat infections, and reduce hearing loss. Dr. Chorney
    and his colleagues suspected, based on their own observations, that tracheostomy-dependent children on a ventilator might be at a higher
    risk of MEE.

    The new study followed 94 children who received a tracheostomy before
    the age of two at Children's Medical Center Dallas between 2015 and
    2020. On average, the children underwent tracheostomy at 5 months old and
    would then periodically obtain hearing tests to determine the presence
    of MEE. In the two years following their tracheostomy, 74% of children requiring mechanical ventilation developed at least one MEE while only 31%
    of those not on the ventilator developed a MEE. When controlling for age, diagnosis of craniofacial syndrome, and result of newborn hearing test, mechanical ventilation predicted the presence of a MEE. Further, among
    all children with a tracheostomy, 80% of MEEs persisted for at least
    several months, between multiple hearing exams.

    "This information allows us to have an objective reference point when communicating with parents," said Dr. Chorney. "We know that this is
    a common phenomenon and we might consider ear tubes in some of these
    children." Since placing ear tubes requires general anesthesia, some
    children with a tracheostomy on ventilator support might not be good
    candidates for the procedure, and the new data helps clinicians weigh
    risks and benefits. In future studies, Dr. Chorney would like to explore
    the impact of MEEs on hearing and communication in this population.

    "What we would hope is that if we're more vigilant with screening for
    and addressing MEEs in these children, positive outcomes on speech and
    language development can be achieved," he said. "But we need more data
    on that."

    ========================================================================== Story Source: Materials provided by UT_Southwestern_Medical_Center. Note: Content may be edited for style and length.


    ========================================================================== Journal Reference:
    1. Erin M. Wynings, Hussein Jaffal, Rachel St. John, Romaine
    F. Johnson,
    Stephen R. Chorney. Mechanical ventilation and middle ear
    effusions among tracheostomy-dependent children. International
    Journal of Pediatric Otorhinolaryngology, 2022; 155: 111062 DOI:
    10.1016/j.ijporl.2022.111062 ==========================================================================

    Link to news story: https://www.sciencedaily.com/releases/2022/04/220404150124.htm

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