The Effect of the COVID-19 Pandemic on Pediatric Tympanostomy Tube Placement.

ABSTRACT

OBJECTIVE: To evaluate how the coronavirus disease 2019 (COVID-19) pandemic has affected tympanostomy tube placement and practice patterns. STUDY DESIGN: A retrospective review of billing data. SETTING: A large-volume practice with both community and tertiary care providers. METHODS: As part of a quality initiative, billing data were queried to identify children <18 years of age who underwent tympanostomy tube placement between January 2019 and December 2020. Patient age, practice location, and case numbers were gathered. RESULTS: The study included data from 2652 patients. Prior to state-mandated clinic and operating room restrictions, there were no significant differences in the number of tympanostomy tubes placed (P = .64), including month-to-month comparisons, the distribution of patients being cared for at community vs tertiary care sites (P = .63), or patient age at the time of surgery (P = .97) between 2019 and 2020. After resumption of outpatient clinical and elective surgical activities, the number of tympanostomy tubes placed decreased significantly between 2019 and 2020 (831 vs 303 cases, P = .003), with a persistent month-to-month difference. In addition, patients undergoing tube placement were older (4.5 vs 3.2 years, P < .001). The distribution of cases performed in the community setting decreased during this time period as well (P < .001). CONCLUSION: During the COVID-19 pandemic, the rate of pediatric tympanostomy tube placement has significantly decreased. The age of patients undergoing surgery has increased, and more children are being cared for in a tertiary setting. These findings may reflect changes in the prevalence of acute and chronic otitis media as the result of the pandemic.