Ventilation Tube Treatment in Children with Otitis Media with Effusion

Abstract

Objective: 1) Discuss the effects of ventilation tube placement on postoperative mastoid growth in children with otitis media with effusion (OME). 2) Show an incidence of postoperative complication, for example, spontaneous extrusion, permanent tympanic membrane perforation. Method: In total, 177 tubes were inserted in 148 ears in 81 children with OME with a mean age of 5.5 years at our hospital from 2001 to 2009. Long-term tubes were used: The T-Tube (Goode) in 87 cases or the Type II tube (Paparella) in 90 cases. Results: The tubes fell out spontaneously in 46%: 61% in the T-Tube group and 32% in the Type II tube group. Postoperative permanent tympanic membrane perforation occurred in 10%. No relationship was observed between the incidence of tympanic membrane perforation and tube type or duration of tube insertion. Postoperative mastoid growth compared to preoperative condition estimated from X-rays was 42%, 55%, 59%, and 65% at 1, 2, 3, and 4 years after surgery, respectively. Retaining the tube in place for more than 3 years was more efficient than doing so for 1 year in terms of mastoid growth statistically. Conclusion: These results indicate that the mastoid air cells grow favorably in children with OME after ventilation tube insertion. The ventilation tube should be removed from the tympanic membrane 3 years or more after insertion from the viewpoint of the mastoid cells growth.