Advantages of Subannular Tube vs Repetitive Transtympanic Tube Technique

Abstract

Insertion of an SAT is a safe and effective method for long-term middle ear ventilation in recurrent or refractory OM, adhesive OM, and retracted tympanic membrane. Associated with fewer complications, SATs offer an alternative to repeated use of the short-term TTTs without damaging the tympanic membrane.

Long‐term outcomes of cartilage‐buttressed T‐tube tympanoplasty for prolonged middle ear ventilation

“…Several prior studies have investigated the utility of a variety of surgical techniques to achieve long‐term middle ear ventilation (Table ). In general, these studies have shown improved middle ear intubation times at the cost of an unacceptably high rate of persistent perforation following tube extrusion or removal …”

“…This technique was further refined by Duckert et al who detailed their experience with 40 cases, reporting a mean duration of intubation of 38 months and no cases of permanent tympanic membrane perforation over 6 years of observation . Alternative techniques have included subannular and transosseous placement of the tympanostomy tube with suboptimal results …”

Tympanoplasty in adhesive otitis media: A descriptive study

“…An alternative to transtympanic VT is to place the tube between the fibrous annulus and bony canal wall (subannular tympanostomy tube); subannular T‐tube (SAT) is said to have a lesser risk of perforation, but it carries risks of chronic plugging of the ventilation tube, skin overgrowth, or tracking of squamous epithelium into the middle ear.…”

“…For Vartiainen et al, tympanoplasty is not recommended in the treatment of chronic AdOM; prevention of chronic AdOM is the best approach. 5 The VT also acts as middle An alternative to transtympanic VT is to place the tube between the fibrous annulus and bony canal wall (subannular tympanostomy tube) 26,30,31 ; subannular Ttube (SAT) is said to have a lesser risk of perforation, but it carries risks of chronic plugging of the ventilation tube, skin overgrowth, or tracking of squamous epithelium into the middle ear.…”

Management of Retraction Pockets

“…The technique consists of drilling in the posterior bony canal wall, after dissection of the skin fl ap together with the annulus, a bony depression to lodge a permanent fi xed aerating tube communicating with the ME cavity without opening the tympanic membrane [ 12 ]. This procedure ensures long-term ventilation of the middle ear without the risk of persistent tympanic membrane perforation as compared to traditional T-tube insertion.…”