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When should retained Paparella type I tympanostomy tubes be removed in asymptomatic children?

In Seok Moon1, Moon Oh Kwon, Chong Yoon Park

  • 1Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.

Auris, Nasus, Larynx
|July 31, 2012
PubMed

Insights

For children with otitis media with effusion (OME), removing tympanostomy tubes after 18 months balances recurrence risk and complications. Early removal before 12 months increases OME recurrence, while later removal after 15 months raises complication risks.

Area of Science:

  • Otolaryngology
  • Pediatric Medicine
  • Medical Device Research

Background:

  • Tympanostomy tubes are standard treatment for otitis media with effusion (OME).
  • Optimal timing for tympanostomy tube removal remains debated.
  • Preschool-aged children are a key demographic for OME treatment.

Purpose of the Study:

  • To determine the ideal removal time for tympanostomy tubes in asymptomatic preschool-aged children.
  • To analyze the relationship between intubation duration and OME recurrence and complications.

Main Methods:

  • Retrospective chart review of 336 patients (478 ears) under 7 years old.
  • Data collected: age at insertion, intubation duration, complications (infection, perforation).
  • Statistical analysis included logistic regression, chi-square, and Fisher's exact tests.

Main Results:

  • Spontaneous tympanostomy tube extrusion plateaued after 18 months (approx. 90% extrusion rate).
  • OME recurrence decreased significantly after 12 months of intubation.
  • Complications, including tube site infection and persistent perforation, increased after 15 months.

Conclusions:

  • Tympanostomy tube removal before 12 months is linked to higher OME recurrence rates.
  • Removal after 15 months is associated with increased complication risks.
  • For asymptomatic children, removing tympanostomy tubes retained beyond 18 months is recommended.
Abstract

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