title: The management of myringotomy tubes in pediatric cochlear implant recipients.
abstract: OBJECTIVE
  To investigate the impact of myringotomy tubes (MTs) on outcomes for pediatric cochlear implant (CI) recipients.
  
  
  METHODS
  Retrospective case-control chart review.
  
  
  METHODS
  Tertiary care pediatric hospital.
  
  
  METHODS
  Sixty-two patients received an MT before CI (mean [SD] age at initial CI, 3.20 [2.45] years). Seventy-eight ears received CIs and MTs.
  
  
  METHODS
  The MTs were removed and allowed to extrude before CI (59% [n = 46]) or kept in place until CI (41% [n = 32]).
  
  
  METHODS
  Otorrhea, persistent tympanic membrane (TM) perforation, and need for additional procedures were recorded. Statistical analysis was performed with the Fisher exact test.
  
  
  RESULTS
  Forty ears (51%) required more than 1 set of MTs. Ten ears (22%) in which the MTs were removed before CI required a separate MT after CI compared with 6 ears (19%) in which the MTs remained in place until CI (P = .78). The MTs that were present during CI were either removed with myringoplasty (31% [n = 10]) or retained after surgery (69% [n = 22]). All TMs in which the tubes were removed before or during CI healed. There were 3 persistent TM perforations that required surgical treatment. There were no cases of meningitis and no removals of CIs because of infection.
  
  
  CONCLUSIONS
  Myringotomy tubes do not appear to adversely affect the final outcomes of pediatric CI recipients and can be managed similarly to MTs in other otitis media-prone children. They may be left in place in children who continue to experience recurrent acute otitis media or removed in children who no longer need them.
authors.affiliation: Pediatric ENT Associates, 1940 Elmer Bissell Rd, Birmingham, AL 35243, USA.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Barañano
authors.forename: Richard S
authors.initials: RS
authors.lastname: Sweitzer
authors.forename: Mandy Lutz
authors.initials: ML
authors.lastname: Mahalak
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Alexander
authors.forename: Audie L
authors.initials: AL
authors.lastname: Woolley
mesh_terms: D002558:Cerebrospinal Fluid Otorrhea / Q000209:etiology; D002675:Child, Preschool; D019929:Cochlear Implantation; D003054:Cochlear Implants; D005260:Female; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects; D009225:Myringoplasty; D010033:Otitis Media / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology