Compliance with tympanostomy tube insertion guidelines in Finland.

Abstract

Backround: Tympanostomy tube insertion (TTI) is the most common pediatric surgical procedure in otorhinolaryngology.

Objectives: To evaluate the appropriateness of TTI in relation to national recommendations in Finland. As a secondary aim, we assessed long term ear-related quality of life if surgical criteria are unmet.

Materials and methods: We retrospectively reviewed all TTI procedures performed on children under 10 years of age in 2019 in Turku University Hospital, Finland. Factors contributing to the operation were identified and evalued in detail. In 2021, caregivers received a questionnaire including Otitis Media 6 -questionnaire to assess ear-related quality of life.

Results: A total of 355 operations were analyzed. The national criteria for recurrent acute otitis media were met in 119/355 cases (33%) and chronic otitis media with effusion criteria in 81/355 (23%), while 155/355 (44%) did not fulfil either criterion. Ear-related quality of life was high across all groups with no significant differences observed.

Conclusions and significance: The substantial proportion of procedures conducted outside Finnish recommendations underlines the necessity for continuous professional education and systematic evaluation of clinical decision-making. Observed discrepancies between Finnish and international guidelines further support the re-evaluation of Finnish criteria to ensure alignment with global standards and evidence-based practice.