Objective: PI technique for providing long-term ventilation of the middle e
ar (ME) during tympanoplasty is described, and the results using this techn
ique in 20 patients with chronic Eustachian tube dysfunction (ETD) are repo
rted.
Study Design: This study was a retrospective, nonrandomized case review.
Setting: This study was conducted at an otology clinic in a tertiary referr
al center.
Patients: Twenty consecutive patients who underwent tympanoplasty with ETD,
adhesive otitis media, or chronic otitis media with perforation were inclu
ded in this study.
Intervention: All patients had a subannular T-tube placed anteriorly at the
time of tympanoplasty for long-term ventilation of the ME space.
Main Outcome Measures: The two main outcome measures were tube position and
patency. Preoperative and postoperative hearing levels were also tested in
most patients, and any complications were documented.
Results: Twenty patients (20 ears) received anterior subannular T-tubes at
the time of tympanoplasty. Fourteen females and 6 males were evaluated (med
ian age, 36 years; range, 7 to 72 years). All patients had ETD; 7 had adhes
ive otitis media, 10 had chronic otitis media, 8 had cholesteatoma, and 2 h
ad cleft palate. All patients had conductive hearing loss and previous surg
ery. All patients underwent tympanoplasty; 11 had concomitant ossiculoplast
y, and 5 had mastoidectomy. Follow-up ranged from 8 to 22 months (mean, 13.
4 months). One patient was lost to followup. One tube extruded after 16 mon
ths, Two patients had persistent mild retraction of the tympanic membrane.
All other tubes are patent and have not migrated or plugged. There has been
no evidence of anterior blunting or ingrowth of epithelium around the tube
.
Conclusions: Anterior subannular T-tube placement is a simple, safe, and ef
fective alternative for long-term ME ventilation in patients in whom standa
rd transtympanic sites are not available. At their last follow-up visit, al
l but one patient had a patent tube. All MEs were aerated. This technique o
ffers the advantage of ease of placement during simultaneous tympanoplasty,
mastoidectomy, or ossiculoplasty. Longer follow-up is necessary to confirm
these initial findings.