title: Factors related to persisting perforations after ventilation tube insertion.
abstract: OBJECTIVE
  Over a million ventilation tubes are placed annually in the United States, making this one of the most commonly performed procedures in the field of medicine. Certain factors increase the risk of persistent tympanic membrane perforation following the extrusion of short term ventilation tubes. Persistent perforations may fail to heal on their own, necessitating surgical closure to avoid conductive hearing loss. It is important to detect factors that may predict children who are at increased risk for persistent perforations.
  This study was a retrospective chart review that involved 757 patients between 2003 and 2008. The patients studied were within the age of 2 months-17 years, and all had short term tubes placed. The chart data also included demographic information, comorbidities, and information related to tube insertion and follow-up care. Chi-square, t-test, and multivariate logistic regression were conducted to compare variables between patients with perforations and those without.
  
  
  RESULTS
  Data from 757 patients was analyzed, showing that perforation rate is associated with rhinorrhea, operative tube removal, aural polyps, and otorrhea (OR 1.72, 8.16, 4.69, and 1.72 respectively). The absence of otorrhea decreased the likelihood of TM perforations and no significant differences were found in gender, total number of sets of tubes, type of tube, use of nasal steroids, adenoidectomy, or nasal congestion.
  
  
  CONCLUSIONS
  Our findings suggest that children with rhinorrhea, otorrhea, aural polyps, or prolonged intubation requiring operative tube removal should be identified clinically as children at risk of persisting perforation.
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: aoconnell2@hmc.psu.edu.
authors.forename: Ashley P
authors.initials: AP
authors.lastname: O'Connell Ferster
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
authors.forename: April Michelle
authors.initials: AM
authors.lastname: Tanner
authors.affiliation: The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: kkarikari@hmc.psu.edu.
authors.forename: Kodjo
authors.initials: K
authors.lastname: Karikari
authors.affiliation: The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: croberts2@hmc.psu.edu.
authors.forename: Christopher
authors.initials: C
authors.lastname: Roberts
authors.affiliation: Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: derekwiltz@ololcollege.edu.
authors.forename: Derek
authors.initials: D
authors.lastname: Wiltz
authors.affiliation: Department of Surgery and Department of Pediatrics, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033, USA. Electronic address: mcarr@hmc.psu.edu.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Carr
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D018058:Tympanic Membrane Perforation / Q000453:epidemiology / Q000209:etiology*
keywords: Tympanic membrane perforation; Tympanostomy; Ventilation tubes