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Factors Related to Ventilation Tube Extrusion Time in Children and Adults
Yi-Chih Lin1, Yi-Lin Kao2, Yen-Chun Chen3
1Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei.
Insights
Ventilation tube (VT) extrusion time is influenced by prior VT insertion history and tube size. Larger tubes and no prior history correlate with longer retention, aiding clinical decisions for pediatric and adult ear tube management.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Medical Device Research
Background:
- Ventilation tube (VT) insertion is a common procedure for middle ear effusions.
- Understanding factors influencing VT extrusion time is crucial for optimizing patient outcomes.
- Variability in extrusion time necessitates investigation into predictive factors.
Purpose of the Study:
- To identify factors affecting ventilation tube (VT) extrusion time in pediatric and adult patients.
- To provide data for improved clinical decision-making and follow-up strategies.
- To enhance understanding of VT retention dynamics.
Main Methods:
- Retrospective analysis of 447 patients undergoing myringotomy with VT insertion.
- Inclusion of variables: age, gender, prior VT history, tympanogram, VT size, tympanic membrane findings, and comorbidities.
- Statistical analysis to determine the impact of these factors on VT extrusion time.
Main Results:
- Overall average extrusion time was 225.85 days (children: 221.3 days, adults: 231.0 days).
- Longer extrusion time was observed in patients without prior VT insertion and with larger VT sizes in both age groups.
- Male gender impacted extrusion time in children; prior VT history and VT size were key factors for early extrusion in children.
Conclusions:
- Prior ventilation tube (VT) insertion history and VT size are significant predictors of extrusion time in both children and adults.
- Avoiding VTs with a diameter less than 1 mm and considering larger sizes for patients with a history of VT insertion may optimize retention.
- Findings support tailored approaches to VT selection for improved clinical outcomes.
Background And Objective:
The aim of this study was to investigate the factors affecting extrusion time in both children and adults with ventilation tube (VT) insertion, providing useful information for clinicians for better decision-making, follow strategy, and potentially improve clinical outcomes for these patients.
Methods:
Data from patients receiving myringotomy with VT insertion from January 1, 2007, to June 30, 2012, were retrospectively collected and analyzed by the end of 2018. Various factors, including age, gender, history of VT insertion, tympanogram, size of VT used, local finding of tympanic membrane, hypertension, diabetes mellitus, hyperlipidemia, and postoperative ear infection, were included and analyzed to examine the effects of these factors on extrusion time.
Results:
A total of 447 patients were included in this study (Child group-Adult group = 237:210). The overall average extrusion time was 225.85 days. In the subgroup analysis, the average time was 221.3 days and 231.0 days for children and adults, respectively. The results showed that the VT extrusion time was significantly longer in participants without a history of VT insertion and in those where larger sized VTs were inserted in both age-groups. Male gender had an influence on extrusion time in children. In addition, a history of VT insertion and VT size were determined to be factors related to extrusion before 12 months in children.
Conclusion:
History of VT insertion and VT size were significantly related to VT extrusion time in both children and adults and defined as factors associated with extrusion before 12 months in children. The findings suggest avoiding VT with a diameter < 1 mm and considering an appropriately larger size in patients with a history of VT insertion to optimize VT retention.
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