Ventilation tube removal: does treatment affect perforation closure?

Abstract

The study goal was to determine whether treatment of the tympanic membrane at the time of ventilation tube (VT) removal affects closure of the perforation. We conducted a retrospective chart review and telephone follow-up of children who underwent VT removal from 1995 through 1998. Among 109 patients (162 ears; 58% male), the mean age at VT removal was 6.7 years. Most VTs (59%) were T-tubes, and most (91%) were removed because of prolonged retention (mean 2.3 years). After VT removal, 111 ears (69%) received treatment, most commonly (44%) with 25% trichloroacetic acid (TCA). At the latest follow-up, 151 of the ears (93%) had healed without additional treatment. Treatment failure occurred more frequently in ears not initially treated with TCA (TCA 3% failure, other treatment 13%, no treatment 8%) and in ears with VTs removed because of otorrhea. Most perforations healed. TCA may promote closure, but a large randomized clinical trial is needed to eliminate physician bias.