Shepard grommet tympanostomy tube complications in children with chronic otitis media with effusion

Abstract

The objective of this study was to determine tympanostomy tube complications in children with chronic otitis media with effusion who were treated with Shepard grommet tympanostomy tube insertion. This tube type was selected as it is the most commonly used one in our clinic. The medical records of 162 ears of 87 children (52 male and 35 female) were reviewed retrospectively. The children were between 3 to 16 years old (mean age = 8.1 +/- 3.1). The patients were followed up 6-66 months (mean 23.3 +/- 14.9 months) after tympanostomy tube insertion. We reviewed age, sex, time to tube extrusion and complications. In all patients the indication for surgery was chronic middle ear effusion. Otorrhea occurred in nine ears (5.6%). Granulation tissue was seen in two ears (1.2%). Complications after tympanostomy tube extrusion included myringosclerosis (34.6%), persistent perforation (5.6%), atrophy (23.5%), retraction (16.7%) and medial displacement of tubes (1.2%). The average extrusion time was 8.5 +/- 4.6 months (range 1-24) for Shepard grommet tympanostomy tubes. Complications of tympanostomy tube insertion are common. Myringosclerosis, tympanic membrane atrophy and otorrhea are the most frequently appearing complications. But they are generally insignificant and cosmetic. Consequently, in the majority of these complications there is no need for any management.

Gene expression profile of collagen types, osteopontin in the tympanic membrane of patients with tympanosclerosis

“…12,23 The clinical observations indicate that the frequency of myringosclerosis is much higher in tympanic membranes with tympanostomy tube insertion than in tympanic membranes with no tympanostomy tube insertion (23-70% and 0-13%, respectively). 5,11,[23][24][25][26][27][28][29][30] It was also observed that the myringosclerosis rate increased with a larger size of tube, several tube insertions and time of tympanostomy tube stay. 25,29,31,32 Based on computer modeling, it has been shown that ventilation tube insertion induces shear stress in the structure of the tympanic membrane.…”

“…25,29,34 Typically, tympanosclerotic changes proceed via the destruction of connective tissue followed by fibrosis resulting in elevated deposition of collagens and subsequent calcification of tissues in the middle ear. A recent histological study demonstrated that a healthy human tympanic membrane consists of collagen type I, II, III and IV.…”

Acupressure Bead in the Eustachian Tube

“…Indeed, cases in which tympanostomy tubes, sludge, and ear mould impression material become middle-ear foreign bodies have repeatedly been reported [3][4][5][6][7]. In addition, the prevalence of chronic tympanic membrane perforations is high [8].…”

To remove or not to remove: Review of cases of medial migration of tympanostomy tubes

“…It is estimated that up to 17% of patients who have tympanostomy tubes placed will develop some sort of complications [2,3]. These include otorrhea, peritubal drum atrophy, scarring, granulation tissue, tympanosclerosis, persistant perforation, blockage of the tube lumen, premature extrusion, cholesteatoma formation and tympanostomy tube displacement into the middle ear [4][5][6].…”