COVID-19 Pandemic Mask Mandates and Tympanostomy Tubes in the Pediatric Population

ABSTRACT

Introduction: The COVID-19 pandemic and statewide mask mandates (MM) affected elective surgical procedures throughout the United States, with declines in the prevalence of pediatric otitis media (OM) and tympanostomy tube (TT) placement during the first year of the pandemic. This study aims to follow the trends in OM and TT placement as it presents to our community pediatric hospital before, during, and after the MM, as there are no current studies on this effect. Method(s) Retrospective data collection of patients who received TT placement in the months of July to September before, during, and after Ohio's statewide MM in 2019, 2020, and 2021, respectively. Collected data included patient demographics, symptoms, risk factors, and complications related to OM, intraoperative findings, and postoperative evaluation. Result(s) We identified 542 patients who underwent TT placement before (n=223), during (n=93), and after (n=226) the MM. There were significantly fewer bouts of ear infections reported per patient prior to clinical evaluation in 2021 following MM removal, compared with 2019 (median 4 vs 5, P<.001) and 2020 (median 4 vs 5, P=.003). There were no significant differences in complications due to OM prior to TT placement before, during, or after the MM (6.7% vs 10.8% vs 3.5%, P=.283). There were no significant differences in the median age, perceived hearing or speech concerns, or cigarette smoke exposure at home per year. Significantly more children were attending daycare after the MM than before or after (P<=.01). There was increased severity of middle ear disease with significantly more cases of drainage after the MM in 2021 compared with during (50% vs 30.1%, P=.005). There were no significant differences in postoperative complications. Conclusion(s) The increased severity of OM at time of TT surgery may be associated with the lifting of MM and/or increased daycare attendance in 2021. The COVID-19 pandemic and associated social changes may have a role on elective surgical procedures and middle ear disease in the pediatric population.