[Ventilation tube insertion for treating adult otitis media with effusion]

The etiologic factors and treatment of otitis media with effusion (OME) in children are well described and established. On the contrary, little has been published with regard to OME in adults and its treatment. To further investigate this problem, we reviewed the records of all adult patients who had received ventilation tube (VT) insertion for OME in VGH-Taipei from 1983 to 1986. There were 335 VT insertions performed on 140 adult patients whose follow-up periods were longer than 6 months. Among them, fifty patients received more than one VT insertion due to recurrence of OME in one or both ears. The average follow-up period was more than 4 years. The coexistence of nasal diseases was found in 46% of the adult OME patients. The mean extrusion time of the VT was 10.2 months. After VT insertions, the improvements of mean air conduction and mean air-bone conduction gap were 10.1 and 11.8 dB respectively. After the extrusion or removal of VT, there was no recurrence of OME in 50 ears (14.9%). Recurrence of OME occurred in 199 ears (59.4%). Dry persistent perforations of the eardrums were found in 27 ears (8.1%). Discharging persistent perforations were noted in 24 ears (7.2%). No recurrence of OME was observed in 24.2% of the ears with serous effusion fluids, whereas only 4.8% of the ears with mucoid fluids were free from recurrence during the follow-up period. Post-intubation otorrhea, which was the most common complication, developed in 92 ears (27.5%). Our results suggest that the recurrence rate of OME after extrusion of VT is high in the adult patients.(ABSTRACT TRUNCATED AT 250 WORDS)