Subannular ventilation tubes: retrospective study.
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.
Cloutier
Jean-François
JF
Otolaryngology Program, University of Montreal, Montreal, QC.
Arcand
Pierre
P
Martinez
Jose
J
Abela
Anthony
A
Quintal
Marie-Claude
MC
Guerguerian
Ara Jean
AJ
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