Timing for removal of tympanic ventilation tube in children

Iwaki, Eiko; Saito, Takehisa; Tsuda, Gota; Sugimoto, Chizuru; Kimura, Yuichi; Takahashi, Noboru; Fujita, Kaori; Sunaga, Hiroshi; Saitô, Hitoshi

doi:10.1016/s0385-8146(98)00022-4

Cited by 29 publications

(53 citation statements)

References 25 publications

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“…[16][17][18][19][20][21][22][23][24][25] Length of tube retention was longer in tubes that manufacturers identified as "long-term tubes." Specifically, Goode T-tubes and Paparella tubes were retained longer than Shah and Shepard tubes.…”

Section: Tympanostomy Tube Comparisonsmentioning

confidence: 99%

Surgical Treatments for Otitis Media With Effusion: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVE: The near universality of otitis media with effusion (OME) in children makes a comparative review of treatment modalities important. This study' s objective was to compare the effectiveness of surgical strategies currently used for managing OME. METHODS:We identified 3 recent systematic reviews and searched 4 major electronic databases. Eligible studies included randomized controlled trials, nonrandomized trials, and cohort studies that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting. Using established criteria, pairs of reviewers independently selected, extracted data, rated risk of bias, and graded strength of evidence of relevant studies. We incorporated meta-analyses from the earlier reviews and synthesized additional evidence qualitatively. RESULTS:We identified 41 unique studies through the earlier reviews and our independent searches. In comparison with watchful waiting or myringotomy (or both), tubes decreased time with OME and improved hearing; no specific tube type was superior. Adenoidectomy alone, as an adjunct to myringotomy, or combined with tubes, reduced OME and improved hearing in comparison with either myringotomy or watchful waiting. Tubes and watchful waiting did not differ in language, cognitive, or academic outcomes. Otorrhea and tympanosclerosis were more common in ears with tubes. Adenoidectomy increased the risk of postsurgical hemorrhage.CONCLUSIONS: Tubes and adenoidectomy reduce time with OME and improve hearing in the short-term. Both treatments have associated harms. Large, well-controlled studies could help resolve the riskbenefit ratio by measuring acute otitis media recurrence, functional outcomes, quality of life, and long-term outcomes. Research is needed to support treatment decisions in subpopulations, particularly in patients with comorbidities.

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Section: Tympanostomy Tube Comparisonsmentioning

confidence: 99%

Surgical Treatments for Otitis Media With Effusion: A Systematic Review

et al. 2014

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“…Follow up is advised to continue until the tympanostomy tube extrudes or is removed, with recovery of normal hearing and normal eustachian tube function, together with closure of the tympanic membrane perforation. 2 It would be interesting know more about the study which supplied the quoted figures for persistent perforation and recurrence. The most helpful piece of information would be whether any of the patients undergoing T-tube removal developed other complications such as cholesteatoma.…”

Section: -10mentioning

confidence: 99%

“…Otitis media with effusion is often bilateral and associated with transmission hearing loss, which in childhood can have implications for the child's social and intellectual development. 2 The insertion of ventilation tubes is one of the most common surgical treatments in children with OME resistant to conservative therapy. 1,3 Various types of ventilation tube are available.…”

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confidence: 99%

“…1 In comparison with short-term tubes, which are usually extruded spontaneously within six months, long-term tubes are designed to remain in place for extended periods, and they often need to be surgically removed after the appropriate intubation period. [1][2][3] The most commonly documented complications associated with long-term tubes are otorrhoea, scarring, tympanosclerosis, residual perforation, peritubal drum atrophy and granulation tissue formation. 4,5 Although the indications for ventilation tube insertion have been widely discussed in the literature, 1,3 very few published reports have addressed the appropriate timing for removal of long-term tubes in children, and there is no clear consensus.…”

mentioning

confidence: 99%

“…2 Iwaki et al stated that the appropriate intubation period in children with OME is over 12 months, and that it may be better to postpone extubation until the patient is 8 years of age. 2 Lentsch et al have recommended elective removal of tubes prior to 36 months' intubation. 5 We routinely use silicone Richards T-tubes (1.14 mm internal diameter and 12 mm length) and surgically remove them after an intubation period of 24 months, with simultaneous freshening of the tympanic perforation edges and silicone patch myringoplasty.…”

mentioning

confidence: 99%

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