Skip to main content Accessibility help

Five-year results for use of single-flanged tympanostomy tubes in children

  • J Knutsson (a1) and M von Unge (a1)



To assess the five-year outcome of the use of single-flanged tympanostomy tubes in children, including the time to extrusion, rate of retained tubes and rate of persistent perforation.

Materials and methods:

The medical records relating to 640 single-flanged tympanostomy tubes intended for short-term use in paediatric patients were retrospectively reviewed.

Results and analysis:

We found that 36.4 per cent of the tubes had extruded within 12 months and 71.0 per cent within 24 months. Results showed that 14.1 per cent of the tubes had been removed because of prolonged retention, with a mean time to removal of 38.9 months. The time to extrusion was longer and the rate of retained tubes was higher than those reported for several other short-term tubes. We found that 4.5 per cent of tube insertions had resulted in a persistent perforation, a higher percentage than previously reported for other tubes intended for short-term use. Within five years of tube insertion, 70.5 per cent of the tympanic membranes had normalised.


Corresponding author

Address for correspondence: Dr Johan Knutsson, Dept of Otorhinolaryngology, Västerås Central Hospital, SE-721 89 Västerås, Sweden. Fax: +46 21 175364 E-mail:


Hide All

Part of the study was presented at the XXIX Congress of the Nordic Association of Otolaryngology, June 15–18, 2005, Reykjavik, Iceland.



Hide All
1 Brusis, T, Luckhaupt, H. Perforation of the ear drum. On the history of paracentesis and grommet insertion [in German]. Laryngorhinootologie 1996;75:178–83
2 Armstrong, BW. A new treatment for chronic secretory otitis media. AMA Arch Otolaryngol 1954;59:653–4
3 Kay, DJ, Nelson, M, Rosenfeld, RM. Meta-analysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg 2001;124:374–80
4 Lous, J, Burton, MJ, Felding, JU, Ovesen, T, Rovers, MM, Williamson, I. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev 2005;1: CD001801
5 Franklin, JH, Marck, PA. Outcome analysis of children receiving tympanostomy tubes. J Otolaryngol 1998;27:293–7
6 Urben, SL, Nichols, RD. Tympanostomies with tubes: the parent perspective. Laryngoscope 1996;106:1269–73
7 Bergus, GR, Lofgren, MM. Tubes, antibiotic prophylaxis, or watchful waiting: a decision analysis for managing recurrent acute otitis media. J Fam Pract 1998;46:304–10
8 Weigel, MT, Parker, MY, Goldsmith, MM, Postma, DS, Pillsbury, HC. A prospective randomized study of four commonly used tympanostomy tubes. Laryngoscope 1989;99:252–6
9 Gibb, AG, Mackenzie, IJ. The extrusion rate of grommets. Otolaryngol Head Neck Surg 1985;93:695–9
10 Lindstrom, DR, Reuben, B, Jacobson, K, Flanary, VA, Kerschner, JE. Long-term results of Armstrong beveled grommet tympanostomy tubes in children. Laryngoscope 2004;114:490–4
11 Todd, GB. Audit of the incidence of persistent perforation of the tympanic membrane following grommet removal or extrusion. J Laryngol Otol 1993;107:593–6
12 Van Heerbeek, N, De Saar, GM, Mulder, JJ. Long-term ventilation tubes: results of 726 insertions. Clin Otolaryngol Allied Sci 2002;27:378–83
13 Kim, DS, Moore, PL, Rockley, TJ. Long-term Paparella II grommet use in the management of persistent childhood otitis media: a 5-year follow-up study. Clin Otolaryngol Allied Sci 2004;29:553–7
14 Golz, A, Netzer, A, Joachims, HZ, Westerman, ST, Gilbert, LM. Ventilation tubes and persisting tympanic membrane perforations. Otolaryngol Head Neck Surg 1999;120:524–7
15 Luxford, WM, Sheehy, JL. Myringotomy and ventilation tubes: a report of 1,568 ears. Laryngoscope 1982;92:1293–7
16 Levine, S, Daly, K, Giebink, GS. Tympanic membrane perforations and tympanostomy tubes. Ann Otol Rhinol Laryngol Suppl 1994;163:2730
17 Oluwole, M, Mills, RP. Tympanic membrane perforations in children. Int J Pediatr Otorhinolaryngol 1996;36:117–23
18 Klingensmith, MR, Strauss, M, Conner, GH. A comparison of retention and complication rates of large-bore (Paparella II) and small-bore middle ear ventilating tubes. Otolaryngol Head Neck Surg 1985;93:322–30
19 Hern, JD, Hasnie, A, Shah, NS. A long-term review of the Shah Permavent tube. J Laryngol Otol 1995;109:277–80
20 Armstrong, BW. Prolonged middle ear ventilation: the right tube in the right place. Ann Otol Rhinol Laryngol 1983;92:582–6
21 Hampton, SM, Adams, DA. Perforation rates after ventilation tube insertion: does the positioning of the tube matter? Clin Otolaryngol 1996;21:548–9
22 Hern, JD, Jonathan, DA. Insertion of ventilation tubes: does the site matter? Clin Otolaryngol 1999;24:424–5
23 Solomon, PR, Lax, MJ, Smitheringale, AJ. Tympanic membrane perforation following ventilation tube removal in a pediatric setting: a historical study. J Otolaryngol 1993;22:48–9
24 Schwartz, KM, Orvidas, LJ, Weaver, AL, Thieling, SE. Ventilation tube removal: does treatment affect perforation closure? Otolaryngol Head Neck Surg 2002;126:663–8
25 Valtonen, HJ, Qvarnberg, YH, Nuutinen, J. Otological and audiological outcomes five years after tympanostomy in early childhood. Laryngoscope 2002;112:669–75


Related content

Powered by UNSILO

Five-year results for use of single-flanged tympanostomy tubes in children

  • J Knutsson (a1) and M von Unge (a1)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.