title: Subannular ventilation tubes: retrospective study.
abstract: OBJECTIVE
  To evaluate the efficiency of a subannular tube insertion technique in a group of pediatric patients with adhesive otitis or severe atelectasis of the tympanic membrane.
  
  
  METHODS
  Retrospective nonrandomized case series.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  The main outcomes of this study are tube duration according to the type of tube used, the complication rate, and the audiometric gain associated with this procedure.
  
  
  RESULTS
  The study group consisted of 190 patients (316 tubes) aged between 3 and 19 years (average 9 years old) and operated on between 1993 and 1999 by four pediatric otolaryngologists. The average follow-up was 53 months. The tubes remained in place for an average of 21.8 months, with fluoroplastic tubes lasting 17.8 months and Goode T tubes lasting 23.8 months. When used in children between 5 and 9 years of age and in cases of adhesive otitis, Goode T tubes showed statistically significantly better results than fluoroplastic tubes. The complications of this technique were otorrhea (17.7%), perforation (7.9%), a plugged tube (7.0%), and cholesteatoma (1.6%). The 5- to 9-year-old group and the reintervention group of patients showed statistically higher complication rates compared with all other groups. Sixty-four patients (128 tubes) were eligible for audiogram analysis, which showed a gain of 13.4 dB (speech reception threshold).
  
  
  CONCLUSIONS
  The technique of subannular tube insertion is a safe and effective method for long-term middle ear ventilation in cases of adhesive otitis or severely atelectatic tympanic membrane or for patients with pathology related to dysfunction of the eustachian tube. It offers an alternative to repeated short-term tube insertions for otitis media with effusion or recurrent acute otitis media.
authors.affiliation: Otolaryngology Program, University of Montreal, Montreal, QC.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cloutier
authors.forename: Pierre
authors.initials: P
authors.lastname: Arcand
authors.forename: Jose
authors.initials: J
authors.lastname: Martinez
authors.forename: Anthony
authors.initials: A
authors.lastname: Abela
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Quintal
authors.forename: Ara Jean
authors.initials: AJ
authors.lastname: Guerguerian
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear; D004427:Ear Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000295:instrumentation / Q000379:methods*; D010033:Otitis Media / Q000601:surgery*; D038781:Otoscopy; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery*; D018058:Tympanic Membrane Perforation; D014433:Tympanoplasty