Tympanic membrane perforation following the removal of ventilation tubes in the presence of persistent aural discharge

Abstract

This study considers the effect of the removal of a ventilation tube from the tympanic membrane of an ear which has been affected with persistent mucopurulent discharge for at least 3 months. The records of 332 patients were reviewed. Thirty-three patients with 34 ears satisfied the entry criteria. Tube removal cured 27 out of 34 ears (79%) of aural discharge within 1 month. The tympanic membrane healing rates were: at 1 month, 14 (41%); at 3 months, 23 (68%); at 6 months, 24 (71%); and at 1 year, 28 (82%). A table is presented comparing perforation rates from different ventilation tube studies.

Surgical indications and outcomes of tympanostomy tube removal

“…A review by Bingham et al in 1988 including nine different types of tympanostomy tubes removed for otorrhea, found a perforation rate of 29% at 6 months [11].…”

Role of Albumin Coating of Tympanostomy Tubes: Long‐Term Clinical Evaluation

“…This may be because clinical practice recommendations are not strictly followed. According to the literature, the incidence of tympanic membrane perforation after surgical tube removal ranges from 3% to 14% 10 . This depends both on the design of the tube used and the maneuvers used during tube removal to prevent perforation 11 …”

“…According to the literature, the incidence of tympanic membrane perforation after surgical tube removal ranges from 3% to 14%. 10 This depends both on the design of the tube used and the maneuvers used during tube removal to prevent perforation. 11 In our prospective study to determine whether human serum albumin (HSA) coating can reduce postinsertion complications of tympanostomy tubes including tube obstruction and otorrhea, a 9-month follow-up showed a significantly lower number of early tube occlusions among HSA-coated versus uncoated tubes.…”

Factors affecting the persistence of tympanic membrane perforation developed with the extubation of ventilation tube

“…In many centers, 6 months is considered the cutoff for the definition of a permanent perforation. Bingham foration; they showed that a perforation might still heal for up to 1 year [6]. Because the perforations did not heal after 6 months in our study, we defined permanent perforation as a perforation lasting longer than 6 months, similar to many other centers.…”

“…In order to reduce the permanent perforation rate following tube removal, a variety of methods have been employed such as freshening of the edges of the perforation and Gelfilm patch, Gelfoam plugging, paper patch, Steri-strip TM (3M) patch, fat plugging and cauterization with trichloroacetic acid [1,[3][4][5][6][7][8][9][10][14][15][16][17][18]. However, it is unclear whether the TM should be actively treated to encourage closure or whether the defect should be observed and allowed to close spontaneously [9].…”