Effect of Tympanostomy Tube Removal Technique on Surgical Success and Operative Time

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2025-01-31 DOI:10.1002/lary.31957

Nicole L. Aaronson MD, MBA, Allison Blackwell PA-C, Onyinyechi Kenine, Emily Vanella, Zhaoying Lu PhD, Heather Nardone MD

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Abstract

Objective

Tympanostomy tube removal is a common procedure, the most common complication of which is persistent perforation. Multiple surgical techniques exist. This study seeks to determine whether the technique used affects success rate or surgical time.

Methods

This was a retrospective cohort study in a tertiary-care children's hospital. Tube removal procedure codes were used to extract charts from 2008 to 2023. Data were collected on surgical technique, success, operative time, indications, and patient factors. Primary outcome measure was surgical success, defined as no residual perforation.

Results

A total of 1562 patient ears were analyzed. Success rate was 95.5% for trichloroacetic acid (TCA) myringoplasty with patch, 86.5% for cold myringoplasty with patch placement (CMwP), 74.7% for cold myringoplasty without patch placement (CMsP), and 73.8% for tube removal alone (TR). TR as compared with CMsP did not show a difference in closure rates (p = 1.0000). CMwP was more likely to be successful than TR (p = 0.0162) or CMsP (p = 0.0117). TCA was more likely to be successful than CMwP (p = 0.0197). Median operative time was 4 min for TR, CMsP, and CMwP and 5 min for TCA. This difference in operative time between the groups was statistically significant (p < 0.001).

Conclusion

TCA myringoplasty with patch shows greater surgical success rate than cold myringoplasty with patch, cold myringoplasty without patch, or tube removal alone, but it has a longer operative time. Cold myringoplasty with patch has greater surgical success than cold myringoplasty without patch or tube removal alone.

Level of Evidence

3 Laryngoscope, 135:2171–2175, 2025

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鼓室造口管移除技术对手术成功率和手术时间的影响

目的：鼓膜造口管拔除术是一种常见的手术方法，其最常见的并发症是持续性穿孔。存在多种手术技术。本研究旨在确定所使用的技术是否会影响成功率或手术时间。方法：这是一项在一家三级保健儿童医院进行的回顾性队列研究。取管程序代码用于提取2008年至2023年的图表。收集手术技术、手术成功率、手术时间、指征和患者因素的数据。主要预后指标是手术成功，定义为无残留穿孔。结果：共分析1562例患者耳。三氯乙酸（TCA）鼓膜贴片成形术的成功率为95.5%，冷鼓膜贴片成形术（CMwP）的成功率为86.5%，冷鼓膜成形术（CMsP）的成功率为74.7%，单纯拔管（TR）的成功率为73.8%。与CMsP相比，TR在关闭率上没有差异（p = 1.0000）。CMwP比TR （p = 0.0162）或CMsP （p = 0.0117）更容易成功。TCA比CMwP更容易成功（p = 0.0197）。TR、CMsP和CMwP的中位手术时间为4分钟，TCA的中位手术时间为5分钟。结论：TCA贴片鼓膜成形术的手术成功率高于单纯贴片冷鼓膜成形术、不加贴片冷鼓膜成形术和单纯拔管，但手术时间较长。冷鼓膜成形术与贴片有更大的手术成功率比冷鼓膜成形术没有贴片或管单独去除。证据等级：3喉镜，2025。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects