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Ventilation tube removal. Indications for paper patch myringoplasty
E A Pribitkin1, S D Handler, L W Tom
1Division of Otolaryngology, Children's Hospital of Philadelphia, PA 19104.
Insights
Paper patch myringoplasty is effective for children undergoing ventilation tube removal, especially those with multiple prior tube placements. This procedure shows similar overall healing rates to simple tube removal.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Surgical Outcomes
Background:
- Paper patch myringoplasty is frequently performed after ventilation tube removal in children.
- Limited literature documents the efficacy of this procedure in pediatric otolaryngology.
Purpose of the Study:
- To evaluate the efficacy of paper patch myringoplasty following ventilation tube removal in children.
- To identify factors influencing tympanic membrane healing after tube removal.
Main Methods:
- A retrospective review of 163 ventilation tube removals in 131 children (aged 1-18 years) over 18 months.
- Comparison of healing rates between ears undergoing simple tube removal and those receiving paper patch myringoplasty.
- Analysis of variables such as prior tube placements and tube size.
Main Results:
- Overall healing rates at 6 months were similar between simple tube removal (87%) and paper patch myringoplasty (85%).
- Paper patch myringoplasty significantly improved healing rates (93% vs. 61%) in ears with more than three previous tube placements.
- Healing after simple tube removal was influenced by the frequency and size of previous ventilation tubes.
Conclusions:
- Paper patch myringoplasty is a valuable adjunct for managing tympanic membrane perforations in children with a history of multiple ventilation tube placements.
- The decision to perform paper patch myringoplasty should consider the patient's history of ventilation tube usage.
Abstract:
Paper patch myringoplasties are commonly performed in children at the time of ventilation tube removal, yet no series documenting their efficacy appears in the otolaryngology literature. Over an 18-month period at the Children's Hospital of Philadelphia (Pa), 163 ventilation tube removals were performed on 131 children aged 1 to 18 years. In 95 of these ears, a paper patch myringoplasty was performed after tube removal. No significant difference (87% vs 85%) in the overall healing rate at 6 months was shown between these two groups. An analysis of the variables potentially affecting outcome revealed that healing following simple tube removal was influenced by the frequency of tube placement and by tube size. Paper patch myringoplasty significantly improved outcome (93% vs 61%) in ears with more than three previous tube placements.