Subannular tubes - An alternative for long term tympanic ventilation

Authors

  • João Oliveira Seixas Serviço de Otorrinolaringologia, Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Ricardo Damaso Serviço de Otorrinolaringologia, Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Inês Delgado Serviço de Otorrinolaringologia, Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Patrícia Melo Serviço de Otorrinolaringologia, Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Herédio Sousa Serviço de Otorrinolaringologia, Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Isabel Oliveira Martins Serviço de Otorrinolaringologia, Centro Hospitalar Universitário de Lisboa Central, Portugal
  • Ezequiel Barros Serviço de Otorrinolaringologia, Centro Hospitalar Universitário de Lisboa Central, Portugal

DOI:

https://doi.org/10.34631/sporl.848

Keywords:

otitis media with effusion, pars tensa retraction, subannular tube, long term ventilation tube

Abstract

Objectives: To describe the results of subannullar tube placement in pediatric patients with pars tensa retraction. 

Study design: Observational transversal retrospective study. 

Materials and methods: Clinical records of patients submitted to subannullar tube placement between 2008 and 2019 were evaluated for medical history and clinical and audiological outcomes. 

Results: Fifteen patients (18 ears) were included, with an average age of 9.4 and an average follow-up of 47 months. The most common comorbidities were rhinitis (47%) and palatine cleft (29%). All patients presented pars tensa retraction and 56% had middle ear effusion. Some patients were simultaneously submitted to mastoidectomy with tympanoplasty (50%), tympanoplasty alone (39%) and/or adenoidectomy (33%). Tube extrusion occurred in 44% of ears, on average after 42 months. Tube obstruction (39%), otorrhea (17%) and residual perforation (17%) were the leading complications. Pars tensa retraction resolved in 94%. Air conduction pure tone average improved 8.2dB. 

Conclusions: Subannullar tubes appear to be a viable alternative for middle ear ventilation. 

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References

Sheahan P, Miller I, Sheahan JN, Earley MJ, et al. Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. Int J Pediatr Otorhinolaryngol

. 2003 Jul;67(7):785-93. doi: 10.1016/s0165-5876(03)00098-3.

Cheng X, Sheng H, Ma R, Gao Z. et al. Allergic rhinitis and allergy are risk factors for otitis media with effusion: A meta-analysis. Allergol Immunopathol (Madr). Jan-Feb 2017;45(1):25-32. doi: 10.1016/j.aller.2016.03.004.

Kay DJ, Nelson M, Rosenfeld RM. Meta-analysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg. 2001 Apr;124(4):374-80. doi: 10.1067/mhn.2001.113941.

Saliba I, Boutin T, Arcand P, Froehlich P. et al. Advantages of subannular tube vs repetitive transtympanic tube technique. Arch Otolaryngol Head Neck Surg. 2011 Dec;137(12):1210-6. doi: 10.1001/archoto.2011.197.

Cassano M, Cassano P. Retraction pockets of pars tensa in pediatric patients: Clinical evolution and treatment. Int J Pediatr Otorhinolaryngol. 2010 Feb;74(2):178-82. doi: 10.1016/j.ijporl.2009.11.004.

Simonton KM. Ventilation Tympanotomy: Tunnel Technique. Arch Otolaryngol. 1968 Jun;87(6):644. doi: 10.1001/archotol.1968.00760060646018.

Yang N, Beaudoin PL, Nguyen M, Maillé H. et al. Subannular ventilation tubes in the pediatric population: Clinical outcomes of over 1000 insertions. Int J Pediatr Otorhinolaryngol. 2020 Apr;131:109859. doi: 10.1016/j.ijporl.2020.109859.

Sadé J, Berco E. Atelectasis and Secretory Otitis Media. Ann Otol Rhinol Laryngol. Mar-Apr 1976;85(2 Suppl 25 Pt 2):66-72. doi: 10.1177/00034894760850S214.

Redaelli De Zinis LO, Nassif N, Zanetti D. Long-term results and prognostic factors of underlay myringoplasty in pars tensa atelectasis in children. JAMA Otolaryngol Head Neck Surg. 2015 Jan;141(1):34-9. doi: 10.1001/jamaoto.2014.2804.

Daudia A, Yelavich S, Dawes PJD. Long-term middle-ear ventilation with subannular tubes. J Laryngol Otol. 2010 Sep;124(9):945-9. doi: 10.1017/S0022215110000897.

Jassar P, Coatesworth A, Strachan DR. Long-term ventilation of the middle ear using a sub-annular tympanotomy technique: A follow-up study. J Laryngol Otol. 2004 Dec;118(12):933-6. doi: 10.1258/0022215042790510.

Cloutier JF, Arcand P, Martinez J, Abela A. et al. Subannular ventilation tubes: Retrospective study. J Otolaryngol. 2005 Oct;34(5):312-6. doi: 10.2310/7070.2005.34503.

Published

2021-06-09

How to Cite

Oliveira Seixas, J., Damaso, R., Delgado, I., Melo, P., Sousa, H., Oliveira Martins, I., & Barros, E. (2021). Subannular tubes - An alternative for long term tympanic ventilation. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 59(2), 147–151. https://doi.org/10.34631/sporl.848

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Original Article