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Long-term follow-up of children inserted with T-tubes as a primary procedure for otitis media with effusion

D Strachan1, G Hope, M Hussain

  • 1Bradford Royal Infirmary, ENT Unit.

Clinical Otolaryngology and Allied Sciences
|December 1, 1996
PubMed

Insights

T-tube insertion for otitis media with effusion in children resulted in a significantly higher rate of tympanic membrane perforation compared to Shepard grommets. Long-term outcomes showed no significant differences in other aspects.

Area of Science:

  • Otolaryngology
  • Pediatric Otology
  • Surgical Outcomes

Background:

  • Otitis media with effusion (OME) is common in children.
  • Tympanostomy tubes are frequently inserted to manage OME.
  • Long-term comparisons of different tube types are essential.

Purpose of the Study:

  • To compare the long-term efficacy and safety of T-tubes versus Shepard grommets for OME.
  • To evaluate tympanic membrane outcomes, including perforation rates, after T-tube insertion.

Main Methods:

  • Retrospective review of 90 children undergoing primary T-tube insertion for OME.
  • Comparison with a matched cohort receiving Shepard grommets.
  • Clinical review at least 6 years post-surgery.

Main Results:

  • No significant differences in pre-operative symptoms, operative findings, hearing loss, or tympanic membrane retraction/tympanosclerosis.
  • A significantly higher perforation rate (24%) in the T-tube group versus the Shepard grommet group (2%).
  • Perforation risk correlated with the duration of T-tube ventilation.

Conclusions:

  • T-tube insertion for OME is associated with a substantially increased risk of tympanic membrane perforation.
  • Shepard grommets appear safer regarding perforation risk in the long term.
  • Duration of ventilation tube placement is a critical factor for perforation risk.

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