Audit of the incidence of persistent perforation of the tympanic membrane following grommet removal or extrusion

Abstract

The incidence of persistent perforation following grommet removal or extrusion in 210 ears was assessed, and found to be zero per cent. Collar button grommets were retained longer than Shepard grommets, and the percentage of ears requiring two or more tube insertions was 51.9 per cent.

Grommets in otitis media with effusion: the most frequent operation in children. But is it associated with significant complications?

“…The overall prevalence is approximately 3% [25], and it is basically associated to the retention time and the number of tube insertions. Conventional fluoroplastic grommets are believed to cause fewer perforations, ranging from 0 to 3% of insertions [6,36,70,72,77]. The overwhelming majority of these perforations heal completely, while persistent perforation is reported in approximately 1.4% of cases [41,42].…”

Five-year results for use of single-flanged tympanostomy tubes in children

“…We found that 36.4 per cent of tubes had extruded after 12 months and 71.0 per cent after 24 months. Todd reported an audit of 186 ears in which 91.4 per cent of Shepard tubes had extruded after 12 months 11 . Gibb et al reported equivalent results for Shepard tubes.…”

“…11 Gibb et al reported equivalent results for Shepard tubes. We found that 36.4 per cent of tubes had extruded after 12 months and 71.0 per cent after 24 months.…”

Care of the Child with Tympanostomy Tubes: A Guide for the Primary Care Physician

“…Persistent perforation after tube extrusion (9)(10)(11)37,38,41,42) Scarring of the tympanic membrane (1,37,38) Atrophic monomeric TM (1,37,38) Granuloma (37,38) Tympanosclerosis (1,37) Cholesteatoma (1,37,38) Migration of tympanostomy tube into middle ear canal (37) Complications of TT may be divided into two groups. The first group includes early complications, which occur while the tube is in place and patent and appear to be directly related to the tube.…”

“…This is less common than tympanosclerosis, with the rate of perforation ranging from 0.5 to 25 percent depending on the type of tube and the number of tubes inserted into the same tympanic membrane over time. Long term tubes have the highest rate of tympanic membrane perforation and short term tubes have a lower frequency (41,42). No preoperative factor completely predicts the development of perforation (43).…”