Tympanosclerosis of the drum in secretory otitis after insertion of grommets. A prospective, comparative study

In 193 consecutive children with bilateral secretory otitis, intubation and adenoidectomy were performed on the right ear and paracentesis on the left. Changes in the ear drum were analysed at re-evaluation one to three years after operation. In ears that had been intubated, tympanosclerosis occurred significantly more frequently (48 per cent) than in ears that had not been intubated (10 per cent). The frequency of atrophy of the pars tensa was the same. Of the right ears, 10 per cent were re-intubated, compared with 23 per cent of the left ears. The cause of the increased frequency of tympanosclerosis in the intubated ears must be mechanical, as decreased movements of the drum with inflammatory fibrous hyperplasia impede spontaneous normalization and promote hyalinization and calcification. The hearing was found to be similar in ears with and without tympanosclerosis.