Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T12:29:59.976Z Has data issue: false hasContentIssue false
  • English
  • Français

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: anurag.daudia@nbt.nhs.uk
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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