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Survival and Outcomes of Type I Ventilation Tubes Insertion in Adult Adhesive Otitis Media: A Longitudinal Analysis
Seong Hoon Bae1,2, Dae Hyun Kim1, Sung Il Cho3
1Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Objective:
To characterize short- and mid-term outcomes of standard type I ventilation tube insertion (VTI) in adults with adhesive otitis media (AdOM).
Study Design:
Retrospective cohort study.
Setting:
Single tertiary referral center.
Patients:
Adults with AdOM graded by Sade classification who underwent type I transtympanic VTI (n=23, 30 ears).
Intervention:
Type I transtympanic VTI (Paparella type I, Medtronic).
Main Outcome Measures:
Four-frequency pure-tone average (PTA₄) and air-bone gap (ABG) at 1 month; tympanic membrane (TM) stage change (Sade classification) at 1 month; tube retention (Kaplan-Meier); and post-extrusion TM sequelae at 12 months.
Results:
At 1 month, mean PTA₄ improved from 29.04±17.06 to 21.71±17.04 dB HL and mean ABG improved from 14.17±11.96 to 7.38±9.65 dB HL (both P <0.001). TM morphology improved as stage 0 increased to 66.7% and stages 3-4 decreased to 13.3% ( P <0.001). Tube retention was 57% at 6 months and 20% at 12 months; retraction recurrence (53.3%) and persistent TM perforation (13.3%) were observed.
Conclusion:
Type I VTI in adult AdOM yields short-term auditory and structural improvements but limited 1-year durability, with frequent recurrence after extrusion.
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