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Anterior subannular T-tube for long-term middle ear ventilation during tympanoplasty.
Am J Otol. 1999 May; 20(3):304-8.AJ

Abstract

OBJECTIVE

A technique for providing long-term ventilation of the middle ear (ME) during tympanoplasty is described, and the results using this technique in 20 patients with chronic Eustachian tube dysfunction (ETD) are reported.

STUDY DESIGN

This study was a retrospective, nonrandomized case review.

SETTING

This study was conducted at an otology clinic in a tertiary referral center.

PATIENTS

Twenty consecutive patients who underwent tympanoplasty with ETD, adhesive otitis media, or chronic otitis media with perforation were included in this study.

INTERVENTION

All patients had a subannular T-tube placed anteriorly at the time of tympanoplasty for long-term ventilation of the ME space.

MAIN OUTCOME MEASURES

The two main outcome measures were tube position and patency. Preoperative and postoperative hearing levels were also tested in most patients, and any complications were documented.

RESULTS

Twenty patients (20 ears) received anterior subannular T-tubes at the time of tympanoplasty. Fourteen females and 6 males were evaluated (median age, 36 years; range, 7 to 72 years). All patients had ETD; 7 had adhesive otitis media, 10 had chronic otitis media, 8 had cholesteatoma, and 2 had cleft palate. All patients had conductive hearing loss and previous surgery. All patients underwent tympanoplasty; 11 had concomitant ossiculoplasty, and 5 had mastoidectomy. Follow-up ranged from 8 to 22 months (mean, 13.4 months). One patient was lost to follow-up. One tube extruded after 16 months. Two patients had persistent mild retraction of the tympanic membrane. All other tubes are patent and have not migrated or plugged. There has been no evidence of anterior blunting or ingrowth of epithelium around the tube.

CONCLUSIONS

Anterior subannular T-tube placement is a simple, safe, and effective alternative for long-term ME ventilation in patients in whom standard transtympanic sites are not available. At their last follow-up visit, all but one patient had a patent tube. All MEs were aerated. This technique offers the advantage of ease of placement during simultaneous tympanoplasty, mastoidectomy, or ossiculoplasty. Longer follow-up is necessary to confirm these initial findings.

Authors+Show Affiliations

Washington University School of Medicine, Department of Otolaryngology, Saint Louis, MO 63110, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10337969

Citation

O'Hare, T, and J A. Goebel. "Anterior Subannular T-tube for Long-term Middle Ear Ventilation During Tympanoplasty." The American Journal of Otology, vol. 20, no. 3, 1999, pp. 304-8.
O'Hare T, Goebel JA. Anterior subannular T-tube for long-term middle ear ventilation during tympanoplasty. Am J Otol. 1999;20(3):304-8.
O'Hare, T., & Goebel, J. A. (1999). Anterior subannular T-tube for long-term middle ear ventilation during tympanoplasty. The American Journal of Otology, 20(3), 304-8.
O'Hare T, Goebel JA. Anterior Subannular T-tube for Long-term Middle Ear Ventilation During Tympanoplasty. Am J Otol. 1999;20(3):304-8. PubMed PMID: 10337969.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anterior subannular T-tube for long-term middle ear ventilation during tympanoplasty. AU - O'Hare,T, AU - Goebel,J A, PY - 1999/5/25/pubmed PY - 1999/5/25/medline PY - 1999/5/25/entrez SP - 304 EP - 8 JF - The American journal of otology JO - Am J Otol VL - 20 IS - 3 N2 - OBJECTIVE: A technique for providing long-term ventilation of the middle ear (ME) during tympanoplasty is described, and the results using this technique in 20 patients with chronic Eustachian tube dysfunction (ETD) are reported. STUDY DESIGN: This study was a retrospective, nonrandomized case review. SETTING: This study was conducted at an otology clinic in a tertiary referral center. PATIENTS: Twenty consecutive patients who underwent tympanoplasty with ETD, adhesive otitis media, or chronic otitis media with perforation were included in this study. INTERVENTION: All patients had a subannular T-tube placed anteriorly at the time of tympanoplasty for long-term ventilation of the ME space. MAIN OUTCOME MEASURES: The two main outcome measures were tube position and patency. Preoperative and postoperative hearing levels were also tested in most patients, and any complications were documented. RESULTS: Twenty patients (20 ears) received anterior subannular T-tubes at the time of tympanoplasty. Fourteen females and 6 males were evaluated (median age, 36 years; range, 7 to 72 years). All patients had ETD; 7 had adhesive otitis media, 10 had chronic otitis media, 8 had cholesteatoma, and 2 had cleft palate. All patients had conductive hearing loss and previous surgery. All patients underwent tympanoplasty; 11 had concomitant ossiculoplasty, and 5 had mastoidectomy. Follow-up ranged from 8 to 22 months (mean, 13.4 months). One patient was lost to follow-up. One tube extruded after 16 months. Two patients had persistent mild retraction of the tympanic membrane. All other tubes are patent and have not migrated or plugged. There has been no evidence of anterior blunting or ingrowth of epithelium around the tube. CONCLUSIONS: Anterior subannular T-tube placement is a simple, safe, and effective alternative for long-term ME ventilation in patients in whom standard transtympanic sites are not available. At their last follow-up visit, all but one patient had a patent tube. All MEs were aerated. This technique offers the advantage of ease of placement during simultaneous tympanoplasty, mastoidectomy, or ossiculoplasty. Longer follow-up is necessary to confirm these initial findings. SN - 0192-9763 UR - https://www.unboundmedicine.com/medline/citation/10337969/Anterior_subannular_T_tube_for_long_term_middle_ear_ventilation_during_tympanoplasty_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=10337969.ui DB - PRIME DP - Unbound Medicine ER -