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Long-term middle-ear ventilation with subannular tubes

Published online by Cambridge University Press:  20 April 2010

A Daudia ,
S Yelavich  and
P J D Dawes
A Daudia*
Affiliation:
Department of ENT Surgery, Southmead Hospital, Bristol, UK
S Yelavich
Affiliation:
Department of ENT Surgery, Wellington Hospital, New Zealand
P J D Dawes
Affiliation:
Department of ENT Surgery, Dunedin Hospital, New Zealand
*
Address for correspondence: Mr A Daudia, ENT Consultant, Dept of ENT Surgery, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. E-mail: [email protected]
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Abstract

Objective:

Long-term tympanostomy tubes are associated with a significant rate of complications, particularly persistent perforation. We describe the outcomes of 57 subannular ventilation tube insertions in 45 consecutive patients.

Design:

Retrospective case series.

Subjects:

We studied 45 consecutive patients with chronic otitis media with effusion and hearing loss (n = 54 cases), associated with adhesive otitis media (n = 7), tympanic membrane retraction (n = 17) and tympanic membrane perforation (n = 3). The mean follow up was 48 months (range, nine to 95 months).

Results:

The mean duration of ventilation for tubes still in situ was 22 months (range, one to 76 months; n = 29), and for tubes which extruded or were removed 23 months (range, one to 85 months; n = 28). The mean improvement in air–bone gap was 14 dB (range, −14 to 35 dB). Complications included blockage (16 per cent), perforation after extrusion (9 per cent), granulation (5 per cent) and infection (4 per cent).

Conclusion:

Subannular ventilation tubes provide an effective option for management of intractable middle-ear effusion and eustachian tube dysfunction.

Keywords

Otitis MediaMiddle Ear VentilationTreatment Outcome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 9 , September 2010 , pp. 945 - 949
Copyright
Copyright © JLO (1984) Limited 2010

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References

1American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Clinical practice guidelines: otitis media with effusion. Pediatrics 2004;113:1412–29CrossRefGoogle Scholar
2Monsell, EM, Harley, RE. Eustachian tube dysfunction. Otolaryngol Clin North Am 1996;29:437–44CrossRefGoogle ScholarPubMed
3Bluestone, CD. Pathogenesis of otitis media: role of eustachian tube. Pediatr Infect Dis J 1996;15:281–91CrossRefGoogle ScholarPubMed
4Weigel, MT, Parker, MY, Goldsmith, MM, Postma, DS, Pillsbury, HC. A prospective randomized study of four commonly used tympanostomy tubes. Laryngoscope 1989;99:252–6CrossRefGoogle ScholarPubMed
5Mandel, EM, Rockette, HE, Bluestone, CD, Paradise, JL, Nozza, RJ. Myringotomy with and without tympanostomy tubes for chronic otitis media with effusion. Arch Otolaryngol 1989;115:1217–24CrossRefGoogle ScholarPubMed
6Boston, M, McCook, J, Burke, B, Derkay, C. Incidence of and risk factors for additional tympanostomy tube insertion in children. Arch Otolaryngol 2003;129:293–6CrossRefGoogle ScholarPubMed
7Valtonen, H, Tuomilehto, H, Qvarnberg, Y, Nuutinen, J. A 14-year prospective follow-up study of children treated early in life with tympanostomy tubes: part 1: clinical outcomes. Arch Otolaryngol 2005;131:293–8CrossRefGoogle ScholarPubMed
8Browning, GG, Gatehouse, S. Prevalence of middle ear disease in the adult British population. Clin Otolaryngol 1992;17:317–21CrossRefGoogle ScholarPubMed
9Kay, DJ, Nelson, M, Rosenfeld, RM. Meta-analysis of tympanostomy tube sequalae. Otolaryngol Head Neck Surg 2001;124:374–80CrossRefGoogle Scholar
10Eliachar, I, Joachims, HZ, Goldsher, M, Golz, A. Assessment of long-term middle ear ventilation. Acta Otolaryngol 1983;96:105–12CrossRefGoogle ScholarPubMed
11Bulkley, WJ, King Bowes, A, Marlowe, JF. Complications following ventilation of the middle ear using Goode T tubes. Acta Otolaryngol 1991;117:895–8Google ScholarPubMed
12Strachan, D, Hope, G, Hussain, M. Long-term follow-up of children inserted with T-tubes as a primary procedure for otitis media with effusion. Clin Otolaryngol 1996;21:537–41CrossRefGoogle ScholarPubMed
13Van Heerbeek, N, De Saar, GMAC, Mulder, JJS. Long-term ventilation tubes: results of 726 insertions. Clin Otolaryngol 2002;27:378–83CrossRefGoogle ScholarPubMed
14Mangat, KS, Morrison, GAJ, Ganniwalla, TM. T-tubes: a retrospective review of 1274 insertions over a 4-year period. Int J Pediatr Otorhinolaryngol 1993;25:119–25CrossRefGoogle ScholarPubMed
15Rosenfeld, RM, Bhaya, MH, Bower, CM, Brookhouser, PE, Casselbrant, ML, Chan, KH et al. Impact of tympanostomy tubes on child quality of life. Arch Otolaryngol 2000;126:585–92CrossRefGoogle ScholarPubMed
16Goode, RL. Long-term middle ear ventilation with T tubes: the perforation problem. Otolaryngol Head Neck Surg 1996;115:500–1Google Scholar
17Per-Lee, JH. Long-term middle ear ventilation. Laryngoscope 1981;91:1063–73CrossRefGoogle ScholarPubMed
18Kim, DS, Moore, PLA, Rockley, TJ. Long-term Paparella II grommet use in the management of persistent childhood otitis media: a 5-year follow-up study. Clin Otolaryngol 2004;29:553–7CrossRefGoogle ScholarPubMed
19Simonton, KM. Ventilation tympanotomy. Arch Otolaryngol 1968;87:644CrossRefGoogle ScholarPubMed
20Jahn, AF. Middle ear ventilation with hydroxylvent tube: review of the initial series. Otolaryngol Head Neck Surg 1993;108:701–5CrossRefGoogle ScholarPubMed
21Silverstein, H. Permanent middle ear aeration. Arch Otolaryngol 1970;91:313–18CrossRefGoogle ScholarPubMed
22Haberkamp, TJ, Silverstein, HL. Permanent middle ear aeration: long-term follow-up of transosseus ventilating tubes. Laryngoscope 1987;97:1145–8CrossRefGoogle Scholar
23Martin-Hirsch, P, Woodhead, CJ, Vize, CE. Long-term ventilation of the middle ear using a tympanotomy technique. J Laryngol Otol 1995;109:1151–4CrossRefGoogle ScholarPubMed
24Jassar, P, Coatesworth, A, Strachan, DR. Long-term ventilation of the middle ear using a sub-annular tympanotomy technique: a follow-up study. J Laryngol Otol 2004;118:933–6CrossRefGoogle Scholar
25Al-Swadi, W, Karlsmose, B, Gaihede, M, Henriksen, SD, Rosberg, J. Long-term treatment of chronic Eustachian tube dysfunction by subannular ventilation tubes. Otol Neurotol 2005;26:301–9Google Scholar
26O'Hare, T, Goebel, JA. Anterior subannular T-tube for long-term middle ear ventilation during tympanoplasty. Am J Otol 1999;20:304–8Google ScholarPubMed
27Elluru, RG, Dhanda, R, Neely, JG, Goebel, JA. Anterior subannular T-tube for prolonged middle ear ventilation during tympanoplasty: evaluation of efficacy and complications. Otol Neurotol 2001;22:761–5CrossRefGoogle ScholarPubMed
28Cloutier, JF, Arcand, P, Nartinez, J, Abela, A, Quintal, MC, Guerguerian, AJ. Subannular ventilation tubes: a retrospective study. J Otol 2005;34:312–16CrossRefGoogle Scholar