(374) Pediatric Otolaryngology Procedure Volume before, during and after COVID-19

Introduction: Pediatric otolaryngology case volumes fell precipitously during the COVID-19 pandemic, as care was delayed or avoided altogether. This study examined pre-, mid-, and post-pandemic case volumes for common operations and the potential subsequent increase in patient age.

Methods: Pediatric tympanostomy tube placement (TT) and adenoidectomy/tonsillectomy (T&A) performed in a 31-hospital health system from January 2018 to June 2023 were queried. ANOVA, t-tests, and linear regression were used to determine differences in case volumes and patient age across time periods and patient race/ethnicity. Pre-pandemic baselines were established for year-over-year percent change analysis.

Results: Baseline case volumes for TT and T&A cases were 3334 and 5168 per year, respectively. Both TT and T&A cases dropped drastically in the last 3-quarters of 2020, dropping to 37% and 58% of baseline. This trend continued throughout the first 6 months of 2021, dropping as low as 27% and 52% of baseline. Volumes began to recover starting the last 6 months of 2021 and rose to 102% and 110% of baseline between July 2022-June 2023. Isolating 2023 data alone (Jan-June), TT volume has maintained 95% of baseline while T&A cases have risen to 125% of baseline. For both TT and T&A, median patient age differed across years (p < 0.0001), increasing during the pandemic to 2.0 (±3.5) vs. 1.9 (±3.1) and 7.1 (±4.9) vs. 6.5 (±4.2) pre-pandemic, respectively. However, while median TT age has become increasingly elevated in 2023 (2.4 ±2.8), median T&A age has essentially returned to normal (6.5 ±3.8). Race/ethnicity was not associated with patient ages or case volumes.

Conclusions: The COVID-19 pandemic significantly decreased pediatric otolaryngology case volume for common procedures early in the pandemic but has rebounded to baseline for TT and has increased for T&A. Future research should elucidate the effects of delayed pediatric otolaryngology care and understanding factors that drive surgical volume.