title: Advantages of subannular tube vs repetitive transtympanic tube technique.
abstract: OBJECTIVE
  To compare the efficiency of the subannular T-tube (SAT) vs that of the repetitive transtympanic Duravent tube (TTT) in children with recurrent or chronic otitis media (OM) with effusion or tympanic membrane retraction and to establish which population would be more likely to benefit from TTTs vs SATs.
  
  
  METHODS
  Medical record review.
  
  
  METHODS
  Tertiary care pediatric center.
  
  
  METHODS
  Children receiving an SAT (234 in 160 patients) or at least 2 TTTs (216 in 111 patients) between January 1, 2002, and December 31, 2006, to allow at least 4 years of follow-up from that period until 2010.
  
  
  METHODS
  Average tube duration and complication rates.
  
  
  RESULTS
  The tubes remained in place for a median of 35 months with SAT and 7 months with TTT (P < .001). Overall complication rates were lower with SAT (otorrhea, 21.4%; perforation, 7.7%; plugged tube, 13.7%; new acute OM, 13.7%; new serous OM, 5.1%; and cholesteatoma, 1.7%) than with TTT (otorrhea, 26.9%; perforation, 5.1%; blocked tube, 20.8%; new acute OM, 23.1%; new serous OM, 37.5%; and cholesteatoma, 0.46%). Differences were statistically significant for otorrhea, blocked tube, and new acute and serous OM (P < .001). With similar rates, TTTs and SATs were used more frequently in acute (P = .26) and serous (P = .32) OM, whereas SATs were placed more often in adhesive OM and retracted tympanic membrane (P < .001).
  
  
  CONCLUSIONS
  Insertion of an SAT is a safe and effective method for long-term middle ear ventilation in recurrent or refractory OM, adhesive OM, and retracted tympanic membrane. Associated with fewer complications, SATs offer an alternative to repeated use of the short-term TTTs without damaging the tympanic membrane.
authors.affiliation: Department of Pediatric Otolaryngology, Sainte-Justine University Hospital Center, 3175 Côte Sainte-Catherine, Montreal, QC, Canada. issam.saliba@umontreal.ca.
authors.forename: Issam
authors.initials: I
authors.lastname: Saliba
authors.forename: Tanguy
authors.initials: T
authors.lastname: Boutin
authors.forename: Pierre
authors.initials: P
authors.lastname: Arcand
authors.forename: Patrick
authors.initials: P
authors.lastname: Froehlich
authors.forename: Anthony
authors.initials: A
authors.lastname: Abela
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods*; D010034:Otitis Media with Effusion / Q000601:surgery*; D010035:Otitis Media, Suppurative / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies