title: Long-term middle-ear ventilation with subannular tubes.
abstract: OBJECTIVE
  Long-term tympanostomy tubes are associated with a significant rate of complications, particularly persistent perforation. We describe the outcomes of 57 subannular ventilation tube insertions in 45 consecutive patients.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  We studied 45 consecutive patients with chronic otitis media with effusion and hearing loss (n = 54 cases), associated with adhesive otitis media (n = 7), tympanic membrane retraction (n = 17) and tympanic membrane perforation (n = 3). The mean follow up was 48 months (range, nine to 95 months).
  
  
  RESULTS
  The mean duration of ventilation for tubes still in situ was 22 months (range, one to 76 months; n = 29), and for tubes which extruded or were removed 23 months (range, one to 85 months; n = 28). The mean improvement in air-bone gap was 14 dB (range, -14 to 35 dB). Complications included blockage (16 per cent), perforation after extrusion (9 per cent), granulation (5 per cent) and infection (4 per cent).
  
  
  CONCLUSIONS
  Subannular ventilation tubes provide an effective option for management of intractable middle-ear effusion and eustachian tube dysfunction.
authors.affiliation: Department of ENT Surgery, Southmead Hospital, Bristol, UK. anurag.daudia@nbt.nhs.uk
authors.forename: A
authors.initials: A
authors.lastname: Daudia
authors.forename: S
authors.initials: S
authors.lastname: Yelavich
authors.forename: P J D
authors.initials: PJ
authors.lastname: Dawes
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D002648:Child; D002908:Chronic Disease; D020878:Device Removal; D005064:Eustachian Tube / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006097:Granulation Tissue; D034381:Hearing Loss / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D010034:Otitis Media with Effusion / Q000150:complications / Q000601:surgery*; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology / Q000601:surgery; D055815:Young Adult