Pars tensa retraction pockets in children: treatment by excision and ventilation tube insertion

Tympanic membrane retraction pockets involving the pars tensa are not uncom mon in clinical practice. Recurrent infections, ossicular erosion and chole steatoma are the recognized sequelae. The management options include survei llance, medical treatment and surgery. The surgical procedures range from g rommet insertion to extensive tympanoplasty procedures. We report our exper ience with simple excision and grommet insertion, performed in 31 ears in 2 6 patients as day cases. The follow-up ranged from 8 to 34 months with a me an of 16 months. The procedure was successful in 23 ears (success rate of 7 4%). Recurrence of retraction occurred in seven ears and in one ear there w as a persistent perforation. Age, previous grommet insertion and severity o f retraction did not have a statistically significant influence on the fina l outcome. We conclude that excision and grommet insertion is a simple, saf e and efficient procedure for the management of tympanic membrane retractio n pockets and can be considered in preference to extensive tympanoplasty.