Medium-term middle ear ventilation with self-manufactured polyethylene T-tubes for the treatment of children with middle ear effusion

Abstract

We present the results of the insertion of self-made polyethylene T-tubes for a period of 15-24 months for the treatment of chronic middle-ear effusion. We compare the outcome of our patients to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time. In a retrospective review of 603 T-tubes inserted in 306 children up to the age of 12 years, charts were reviewed for age, sex, surgical procedure performed, duration of ventilation and complications. In all cases the indication for surgery was chronic middle-ear effusion. The tubes were electively removed by the authors after 15-24 months of ventilation. Spontaneous extrusion was considered a complication. The mean period of ventilation was 20 months. Post-operative otorrhoea was experienced in 6.6 per cent of ears; 4.8 per cent of tubes extruded spontaneously, whereas 3.15 per cent had to be removed earlier than originally planned; 4.9 per cent of ears were re-ventilated at a later date, and 1.49 per cent of ears developed a persistent perforation. We demonstrate that the outcome of patients treated with our self-manufactured tubes for a period of 15-24 months is, in many respects, better or at least comparable to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time, and that the many complications associated with the conventional T-tube can be reduced. We suggest that our favourable outcome may be due to the duration of ventilation, which was controlled to be shorter than the conventional long-term T-tubes and longer than that of grommets.

Otitis media with effusion: Recurrence after tympanostomy tube extrusion

“…The recurrence rates were higher for Shepard grommets than other two tubes [7]. Talmon et al [5] used T-tubes for the treatment of children with OME. They detected that the tubes were retained for 20 months.…”

“…Myringotomy with tympanostomy tube insertion, performed following a failure of medical treatment or no spontaneous resolution of the middle ear effusion, is one of the most frequently performed surgical procedures in children [1][2][3][4][5][6]. Although this procedure is commonly performed, there is no certain consensus respecting the effective length of tube stay in place, the time of tube removal, effect of adenoidectomy and the most appropriate type-tubes.…”

“…They detected that the tubes were retained for 20 months. Reinsertion was performed in 4.9% of ears due to recurrence of effusion [5]. Ahn et al [4] determined that the single tube insertion group had longer mean intubation periods than the triple tube insertion group after the first tympanostomy tube insertion.…”

“…§ Presented at the XXXIth Congress of the Turkish National Otolaryngology and Head and Neck Surgery, 28 October-1 November 2009, Antalya, Turkey. insertion [5,6]. There are many clinical trials, studies, and experimental investigations available regarding the epidemiology, pathogenesis, diagnosis, and treatment of OME and its complications and sequelae.…”

Role of Bacterial Biofilm in Refractory Post Tympanostomy Tube Otorrhea

“…Failure of medical treatment of middle ear effusion frequently ends up with tympanostomy tube (TT) insertion. TT insertion, the placement of a small drainage tube in the tympanic membrane, is the most common surgical procedure performed in children under general anesthesia [2] .…”