Relationship between tympanic membrane perforations and retained ventilation tubes.
OBJECTIVE
To determine the effects of prolonged ventilation tube retention on tympanic membrane healing and the efficacy of patching procedures used concomitantly at the time of tube removal.


METHODS
Retrospective chart review.


METHODS
Tertiary referral academic institution.


METHODS
Seventy-six patients aged 12 years and younger, with a total of 99 ears identified from January 1989 to December 1994. All patients underwent ventilation tube removal for prolonged tube retention or infection unresponsive to medical management. A minimum of 6 months of follow-up was required for inclusion.


METHODS
Ventilation tube removal under general anesthesia, with or without concomitant patching.


METHODS
All medical charts were reviewed for age, sex, indications for tube removal, tube retention time, type of patch used (if any), type of tube, outcome after removal, other medical problems, and previous surgical history.


RESULTS
The perforation rate was significantly higher in children with tubes retained beyond 36 months (P=.02). History of previous adenoidectomy predicted poor outcome, with a rate of 47% vs 17% in patients with no such history (P=.002). Patching did not improve healing. No other patient factors significantly influenced the perforation rate.


CONCLUSIONS
Ventilation tube retention longer than 36 months resulted in an increased perforation rate after surgical removal. Paper patching at the time of tube removal does not improve healing. Prospective studies are needed to confirm these findings and to determine the efficacy of other patching techniques.
Nichols
P T
PT
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown 26506-9200, USA.
Ramadan
H H
HH
Wax
M K
MK
Santrock
R D
RD
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000295:instrumentation*; D009225:Myringoplasty; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D018058:Tympanic Membrane Perforation / Q000209:etiology* / Q000601:surgery; D014945:Wound Healing / Q000502:physiology