Factors influencing tympanostomy tube function and extrusion: a study of 1,127 ears

Shepard, long polyethylene, and Reuter-bobbin tympanostomy tubes were studied for longevity in the inferior and anterior quadrants of 1,127 tympanic membranes. Factors that improved tube functioning time significantly for all or certain tube types included (1) general anesthesia; (2) "virgin" tympanic membranes (Shepard, Reuter-bobbin), (3) age of 9 years or younger (Reuter-bobbin), (4) normal or thin tympanic membranes (Reuter-bobbin), and (5) middle ear fluid (Reuter-bobbin for all types of fluid). Negative correlations (or those not statistically significant because of such factors as sample size) for longevity of tube functioning time included (1) effect of multiple previous intubations in the same ear, (2) age over 10 years, and (3) quadrant of insertion. No significant difference in longevity was noted between normal patients and those with a repaired or unrepaired cleft palate deformity. The data suggest that the epithelial layer of the tympanic membrane influences the longevity of the tympanostomy tube function.