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Myringotomy and ventilation tube insertion: a ten-year follow-up

Published online by Cambridge University Press:  29 June 2007

D. N. Riley ,
S. Herberger ,
G. McBride  and
K. Law
D. N. Riley*
Affiliation:
Department of Otolaryngology, Tyrone County Hospital, Omagh, Co. Tyrone, N. Ireland.
S. Herberger
Affiliation:
Department of Otolaryngology, Tyrone County Hospital, Omagh, Co. Tyrone, N. Ireland.
G. McBride
Affiliation:
Department of Otolaryngology, Tyrone County Hospital, Omagh, Co. Tyrone, N. Ireland.
K. Law
Affiliation:
Department of Otolaryngology, Tyrone County Hospital, Omagh, Co. Tyrone, N. Ireland.
*
Address for correspondence: Mr Neil Riley, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland.
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Abstract

Eighty children who had myringotomy performed for otitis media with effusion in 1984 were reviewed in 1994. This had involved surgery on 158 ears. Three aspects of ear condition were studied: hearing loss, tympanic membrane perforation, and tympanosclerosis. Hearing losses were present in 13 ears (8.2 per cent), involving 10 children (12.5 per cent), although losses were under 20 dB in seven of these ears (five patients).

Of the six ears with losses more than 20 dB (3.8 per cent), in five patients bilateral losses of 30 dB were due to a recurrence of effusions, a large dry posterior perforation was the cause of a 30 dB loss, an infected anterior perforation had caused a 30 dB loss, an ear which had a cholesteatoma, and had a mastoidectomy and ossiculoplasty in 1987, had a 30–40 dB loss, and one ear which had a Type I tympanoplasty in 1994 had a 50 dB loss. Therefore in only three ears (1.9 per cent) could hearing loss be associated directly with myringotomy and ventilation tube insertion.

Perforations had persisted unilaterally in seven patients, three having had tympanoplasties. Of the remaining perforated tympanic membranes, two were free of symptoms, one had only a slight hearing loss, and one had a more significant loss with recurrent infection.

Tympanosclerosis was only found in those ears which had ventilation tubes inserted (and not those which had myringotomy only), occurring in 48 ears (31 per cent, or 39 per cent of those which had a ventilation tube inserted).

There was no link between tympanosclerosis and hearing loss. The site of tympanosclerosis was not restricted to the site of myringotomy, and in many cases was present only in other areas of the tympanic membrane. There was a tendency for more extensive tympanosclerosis to occur in those ears which had more ventilation tube insertions. The risk of perforation in particular lends support to a policy of ‘watchful waiting’.

Keywords

Otitis media with effusionMiddle ear ventilation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 3 , March 1997 , pp. 257 - 261
Copyright
Copyright © JLO (1984) Limited 1997

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References

Bernard, P. A., Stenstrom, R. J., Feldman, W., Durieux-Smith, A. (1991) Random controlled trial comparing long-term suiphonamide therapy to ventilation tubes for otitis media with effusion. Paediatrics 88: 215–222.Google Scholar
Browning, G. G. (1986) Tympanic membrane pathology. In Clinical Otology and Audiology (Browning, O. O., ed.) Butterworths, London, P 15.Google Scholar
Isaacs, D. (1994) The management of otitis media with effusion: goodbye to grommets? Current Opinion in Paediatrics 6: 3–6.Google Scholar
Le, C. T., Freeman, D. W., Fireman, B. H. (1991) Evaluation of ventilating tubes and myringotomy in the treatment of recurrent or persistent otitis media. Paediatric Infectious Diseases Journal 10: 2–11.CrossRefGoogle ScholarPubMed
Leopold, D. A., McCabe, B. F. (1980) Factors influencing tympanostomy tube function and extrusion: a study of 1127 ears. Otolaryngology – Head and Neck Surgery 88: 447–454.Google Scholar
Less, T. H. J., Williams, K. K., Skinner, D. W. (1988) Tympanosclerosis. Grommets and shear stresses. Clinical Otolaryngology 13: 375–380.CrossRefGoogle Scholar
Maw, A. R. (1989) Tympanic membrane changes following middle ear effusion and after treatment with ventilation tubes. In Cholesteatoma and Mastoid Surgery (Tos, M., Thomson, J., Peiterson, F., eds.) Kugler and Ghedini, Amsterdam, pp 383–386.Google Scholar
Maw, A. R. (1991) Development of tympanosclerosis in children with otitis media with effusion and ventilation tubes. Journal of Laryngology and Otology 105: 614–617.CrossRefGoogle ScholarPubMed
Parker, A. J., Maw, A. R., Powell, J. E. (1990) Intra-tympanic bleeding after grommet insertion and tympanoscierosis. Clinical Otolaryngology 15: 203–207.Google Scholar
Rach, G. H., Zielhuis, G. A., Van Baarle, P. N., Van den Brock, P. (1991) The effect of treatment with ventilating tubes on language development in pre-school children with otitis media with effusion. Clinical Otolaryngology 16: 128–132.Google Scholar
Roland, N. J., Phillips, E. E., Rogers, J. H., Singh, S. D. (1992) The use of ventilation tubes and the incidence of cholesteatoma in the paediatric population of Liverpool. Clinical Otolaryngology 17: 430–439.Google Scholar
Rosenfeld, R. M., Mandel, E. M., Bluestone, C. D. (1992) Systemic steroids for otitis media with effusion in children. Archives of Otolaryngology, Head and Neck Surgery 117: 984–989.Google Scholar
Slack, R. W. T., Maw, A. R., Capper, J. W. R., Kelly, S. (1984) Prospective study of tympanosclerosis developing after grommet insertion. Journal of Laryngology and Otology 98: 771–884.CrossRefGoogle ScholarPubMed
Tos, M., Bonding, P., Poulsen, G. P. (1983) Tympanosclerosis of the drum in secretory otitis after insertion of grommets. A prospective comparative study. Journal of Laryngology and Otology 97: 489–496.Google Scholar