Ear drum perforations in children after ventilation tube treatment

About 1% of ears treated with straight Teflon tubes get permanent drum perforations after extrusion of the tubes, according to the literature. This paper reports the results of treatment of 20 ears in 17 children who underwent myringoplasty to repair such perforations at a mean age of 9.6 years and with a mean follow-up of 2.4 years. The following history was found: 60% (12/20) perforated after 1 insertion, 47% (9/19) perforated within 12 months after insertion. Seventy percent (14/20) had recurrent infectious problems during tube-treatment and after the perforation was diagnosed. The mean preoperative air-bone gap was 17.9 dB. In 85% (17/20) there was a pure perforation at the site of the previous tube while 3 children had perforations combined with retractions. All drums healed after surgery without serious ventilation problems except in one child. There was no serious infectious problems. The mean postoperative air-bone gap was 10.6 dB. Active removal of long-lasting tubes (> 12 months) is not motivated considering the positive effects of tube treatment in many children and the few perforations that occur. A Teflon tube is a good choice as a standard tube with few perforations that can be successfully surgically treated if self-ventilation and good ear-hygiene is instituted.