Factors Related to Ventilation Tube Extrusion Time in Children and Adults

Abstract

Background and Objective: The aim of this study was to investigate the factors affecting extrusion time in both children and adults with ventilation tube (VT) insertion, providing useful information for clinicians for better decision-making, follow strategy, and potentially improve clinical outcomes for these patients. Methods: Data from patients receiving myringotomy with VT insertion from January 1, 2007, to June 30, 2012, were retrospectively collected and analyzed by the end of 2018. Various factors, including age, gender, history of VT insertion, tympanogram, size of VT used, local finding of tympanic membrane, hypertension, diabetes mellitus, hyperlipidemia, and postoperative ear infection, were included and analyzed to examine the effects of these factors on extrusion time. Results: A total of 447 patients were included in this study (Child group–Adult group = 237:210). The overall average extrusion time was 225.85 days. In the subgroup analysis, the average time was 221.3 days and 231.0 days for children and adults, respectively. The results showed that the VT extrusion time was significantly longer in participants without a history of VT insertion and in those where larger sized VTs were inserted in both age-groups. Male gender had an influence on extrusion time in children. In addition, a history of VT insertion and VT size were determined to be factors related to extrusion before 12 months in children. Conclusion: History of VT insertion and VT size were significantly related to VT extrusion time in both children and adults and defined as factors associated with extrusion before 12 months in children. The findings suggest avoiding VT with a diameter < 1 mm and considering an appropriately larger size in patients with a history of VT insertion to optimize VT retention.

Predictors of tympanostomy tube extrusion time in otitis media with effusion

“…Small TTs extruded prematurely more frequently compared to regular tubes. The finding correlated with Lin et al 15 , who recommended avoiding small TTs in children to prevent premature extrusion. Moreover, Paparella et al 18 recommended choosing TT size based on short-term or long-term purposes.…”

“…Early extrusion of TTs was reported as a factor that increased the recurrence rate in multiple studies. 11 , 15 The present study showed a higher recurrence rate in ears with a shorter TT extrusion time ( Figure 1 ). The ears that had TT for more than 12 months have a recurrence rate of nearly half of those which lasted less than 12 months.…”