A new ventilation tube for long-term middle ear ventilation.
OBJECTIVES: The treatment of secretory otitis media often requires repeated tubulation of the tympanic membrane as the standard ventilation tubes are extruded before the disease of the middle ear has remitted. The T-tube and its modification have been developed to remain longer in situ, often requiring surgical removal. The rates of subsequent persisting tympanic membrane perforations and granulations around the tube have been unacceptably high. In the search for a long-term ventilation tube with fewer complications, the Duravent tube (Smith and Nephew) has been developed. The aim of the study was to estimate duration in situ and observe complications in using the Duravent tube compared with standard tubes and T- tubes. STUDY DESIGN: Retrospective study. METHODS: In all, 51 patients have been treated with the Duravent tube over a 2-year period. In all, 72 Duravent tubes have been inserted. All patients were subsequently invited for a follow-up examination at a median time of 28 months (range, 11-43 mo) after the tube insertion and were followed up for 5 years. RESULTS: The duration in situ was optimal with a median duration of 17 months. The Duravent tube was extruded spontaneously in all but four cases in which surgical removal was necessary. The rate of persisting perforations of the tympanic membrane was low (4.2%) compared with 24% after the use of the T-tube. Likewise, the usual complications connected with long-term ventilation tubes were less frequent (14% compared with 35% when using the T-tube). CONCLUSIONS: In the present study, the Duravent tube has proved superior to other known long-term ventilation tubes. The problem of granulations, otorrhoea, and tube occlusion was significantly less than reported in other studies using the T-tube.