Late results and complications of tympanostomy tube insertion for prophylaxis of recurrent purulent otitis media in pediatric age.
We have evaluated from a clinical and functional point of view a total of 61 children (37 boys and 24 girls with a median age of 3 years, range 4 months to 6 years) who had been submitted before 1978 to insertion of tympanostomy tubes (in a total of 131 ears) for prophylaxis of recurrent purulent otitis media. Of these, 67.6% remained free from recurrencies after removal or extrusion of grommets, whereas in the remaining group discharge could be cured with local and/or general antibiotic treatment. Sixteen cases had tympanic calcifications, 6 an atrophic drum, and 10 a severe tympanic retraction, but only 8 out of these 32 cases had signs of conductive hearing loss (average loss 20 dB on frequencies from 500 to 2000 Hz). Further complications observed in this follow-up have been perforations (6 cases) and one case of migration of the tube into the tympanic cavity. No cholesteatoma has been observed in our series. A few considerations can be drawn from these observations: insertion of grommets, correctly performed in the anterior-inferior part of the drum appears to prevent a large percentage of recurrencies, and should therefore be considered, even in the long-term, an adequate prophylaxis for the otitis-prone child; complications as seen during a long follow-up period are relatively few, can be cured, and have a modest functional impact.
D001301:Audiometry, Pure-Tone; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000601:surgery*; D010035:Otitis Media, Suppurative / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D014945:Wound Healing