What your colleagues think of tympanostomy tubes--28 years later.
OBJECTIVE
Assess the changing opinions of otolaryngologists about tympanostomy tubes, including indications, tube material and shape and size, placement sites, and complications.


METHODS
Cross-sectional survey, compared to the same survey done 28 years earlier.


METHODS
Questionnaires mailed to the 441 active fellows and 86 candidates of the Triological Society. Response rate 69.3%.


RESULTS
The preference for polyethylene has decreased from 75% to 13% of respondents. Preferred insertion sites are more anterior. The proportion of respondents who have seen a permanent perforation as a consequence has increased from 26% to 93%. The proportion of respondents who have seen a tube-attributable cholesteatoma has increased from 8% to 38%. The average tube duration has increased from 4 months to 18 months. Teflon and Silastic are now the materials most often used. As 28 years earlier, about 19% of patients get a subsequent tympanostomy tube. Anesthetics most commonly used now are general or topical phenol.


CONCLUSIONS
The consensus on several aspects of tympanostomy tubes has changed during 28 years. Controversy continues about the indications for using tubes. Although not a not cure-all for otitis media, tympanostomy tubes have proved useful.
Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia 30322, USA. ntodd@emory.edu
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Todd
D003625:Data Collection; D006801:Humans; D008876:Middle Ear Ventilation / Q000295:instrumentation / Q000706:statistics & numerical data*; D010036:Otolaryngology