| アブストラクト | OBJECTIVE: To evaluate the impact of the COVID-19 pandemic on pediatric surgery for otitis media with effusion (OME) in Japan, comparing the general population with high-risk groups (Down syndrome and cleft palate) to differentiate between environmental and anatomical drivers of surgical demand. METHODS: This retrospective cohort study used the Japanese Diagnosis Procedure Combination database (April 2013 to March 2023). Children < 18 years undergoing tympanostomy tube insertion or myringotomy were included. Interrupted time-series (ITS) analysis was employed to estimate immediate "level shifts" and pandemic-period "trend changes," effectively accounting for 10-year pre-existing secular trends to isolate the pandemic's impact. RESULTS: Among 22,748 surgical cases, no significant pre-pandemic trend (+0.05 surgeries/month) was observed, followed by a significant immediate level shift (-107.55 surgeries/month) and a non-significant slope change (0.95 surgeries/month). In contrast, immediate level shifts in the Down syndrome and cleft palate groups were not statistically significant, indicating relatively preserved surgical volume. Concomitant adenoidectomy and tonsillectomy decreased significantly from 38.8% to 29.7% and 23.2% to 16.9%, respectively (p < 0.001). CONCLUSIONS: While OME surgical volume for the general population plummeted, likely due to reduced community-acquired respiratory infections, it remained resilient in high-risk children. These findings suggest that while environmental factors drive OME in the general population, anatomical vulnerabilities necessitate consistent surgical intervention in high-risk groups even during a pandemic. This distinction provides a crucial framework for surgical prioritization in future public health crises. |
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| 投稿者 | Hidaka, Hiroshi; Tarasawa, Kunio; Fujimori, Kenji; Kitawaki, Tomoki; Fushimi, Kiyohide; Ikeda, Ryoukichi; Nakano, Atsuko; Yoshida, Haruo; Kamide, Yosuke; Hashimoto, Ken; Kakuta, Risako; Tochigi, Kosuke; Kasai, Masashi; Kuroki, Haruo; Iino, Yukiko; Kobayashi, Hitome; Horii, Arata; Ito, Makoto |
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| 組織名 | Department of Otorhinolaryngology-Head and Neck Surgery, Kansai Medical;University, Hirakata, Japan.;Department of Healthcare Administration and Policy, Tohoku University Graduate;School of Medicine and Medical IT Center, Tohoku University Hospital, Sendai,;Japan.;Tohoku University, Sendai, Japan.;Department of Mathematics, Kansai Medical University, Hirakata, Japan.;Department of Health Policy and Informatics, Institute of Science Tokyo Graduate;School of Medical and Dental Sciences, Tokyo, Japan.;Department of Otolaryngology-Head and Neck Surgery, Gifu University Graduate;School of Medicine, Gifu, Japan.;Division of Otorhinolaryngology, Chiba Children's Hospital, Chiba, Japan.;Department of Otolaryngology-Head and Neck Surgery, National Hospital;Organization Nagasaki Medical Center, Omura, Japan.;Kamide Ear Nose and Throat Clinic, Fuji, Japan.;Department of Otolaryngology, Jichi Medical University, Shimotsuke, Japan.;Department of Otolaryngology, Tohoku Rosai Hospital, Sendai, Japan.;Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical;University Saitama Medical Center, Koshigaya, Japan.;Department of Infectious Diseases, Hyogo Prefectural Children's Hospital, Kobe,;Pauroom Clinic for Children and Parents, Tokyo, Japan.;Department of Otolaryngology, Tokyo-Kita Medical Center, Tokyo, Japan.;Showa Medical University Graduate School of Health Sciences, Yokohama, Japan.;Department of Otolaryngology-Head and Neck Surgery, Niigata University Graduate;School of Medical and Dental Sciences, Niigata, Japan. |
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