Affiliation:
1. Division of Otolaryngology–Head and Neck Surgery, Department of Surgery Université de Montréal Montreal Quebec Canada
2. Faculty of Medecine Université de Sherbrooke Sherbrooke Quebec Canada
3. Division of Pediatric Otolaryngology–Head and Neck Surgery CHU Sainte‐Justine Montreal Quebec Canada
4. Department of Paediatrics, Faculty of Medicine Université de Montréal Montreal Quebec Canada
5. Department of Paediatrics CHU Sainte‐Justine Montreal Quebec Canada
6. CHU Sainte Justine Research Institute CHU Sainte Justine Montreal Quebec Canada
7. Department of Surgery, Faculty of Medicine Université de Montréal Montreal Quebec Canada
Abstract
ObjectivesTympanostomy tube insertion (TTI) under local anesthesia (LA) is gaining popularity but literature comparing long‐term outcomes for children undergoing TTI under LA versus general anesthesia (GA) is limited. This study compares the long‐term quality of life (QoL) between LA and GA in children undergoing TTI. Secondary objectives included long‐term behavioral changes, parental satisfaction, tube durability, and postoperative complications.MethodsWe prospectively followed children aged under 6 who underwent TTI, under LA or GA, 2 years prior. We assessed QoL using validated scales (OM6, PedsQL), analyzed behavioral changes and parental satisfaction through qualitative scales, and retrieved data on tube durability and non‐immediate complications.ResultsA total of 84 children (LA = 42; GA = 42) had complete data and a minimum of 1 year of follow‐up. Demographic data were similar, except for younger patients in the LA group (1.4 vs. 1.9 years, p = 0.02). LA group exhibited increased fear of health care professionals following TTI (LA: Likert scale 2.1/5, GA: 1.5/5, p = 0.04). Tube retention rate was shorter in the LA group (at 15 months: GA:72%, LA:50%, p = 0.039). Two years post‐TTI, there were no differences regarding QoL (OM‐6 score; LA: 15.2/100, GA: 21.4/100, p = 0.18, and PedsQL score; LA: 84.3/100, GA: 83.8/100, p = 0.90), parental satisfaction with anesthesia (GA: 4.5/5, LA: 4.6/5, p = 0.56), and postoperative complications (GA: 3/42, LA: 7/42, p = 0.18).ConclusionsTTI under LA in children is associated with an increased fear of health care professionals and shorter functionality of tympanostomy tubes as compared to GA. No difference was observed in long‐term QoL, parental satisfaction, and complications rate.Level of EvidenceLevel 3 Laryngoscope, 2024
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