title: When should retained Paparella type I tympanostomy tubes be removed in asymptomatic children?
abstract: OBJECTIVE
  Tympanostomy tubes are routinely used for the treatment of otitis media with effusion (OME). There is no definite consensus on the optimal length of the intubation period and the timing of tube removal. This study was designed to determine the appropriate time for tympanostomy tube removal in asymptomatic patients of preschool age.
  
  
  METHODS
  A retrospective study was conducted in 336 patients (478 ears) under the age of 7 years old who underwent tympanostomy tube insertion or removal from January 2006 to September 2010 at our institution. The information gathered from chart review included patients' age at the time of tube insertion, duration of intubation, and the presence of complications, such as tube site infection and persistent tympanic membrane perforation. Logistic regression, chi-square test and Fisher's exact test were used to determine the statistical significance of observations.
  
  
  RESULTS
  The spontaneous extrusion rate of tympanostomy tubes was about 90% at 18 months and showed a plateau after 18 months. The OME recurrence rate decreased after 12 months of intubation, and complications such as tube site infection and persistent tympanic membrane perforation increased after 15 months of intubation.
  
  
  CONCLUSIONS
  Tympanostomy tubes removed before 12 months showed a high possibility of recurrence. Removal after 15 months showed an increased possibility of complications. Spontaneous extrusion seldom occurred after 18 months. From these findings, we concluded that asymptomatically retained tympanostomy tubes are recommended to remove when a tube is retained for more than 18 months.
authors: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: In Seok
authors: IS
authors: Moon
authors: Moon Oh
authors: MO
authors: Kwon
authors: Chong Yoon
authors: CY
authors: Park
authors: Jae Heon
authors: JH
authors: Lee
authors: Joo Hyun
authors: JH
authors: Kim
authors: Chi Sang
authors: CS
authors: Hwang
authors: Myung-Hyun
authors: MH
authors: Chung
mesh_terms: D058070:Asymptomatic Diseases / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000295:instrumentation*; D010034:Otitis Media with Effusion / Q000601:surgery*; D012189:Retrospective Studies; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome