Long-term middle-ear ventilation with subannular tubes

Abstract

AbstractObjective: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.