The results of a nine-year series of patients who underwent long-term middle ear ventilation using a tympanotomy technique are presented. The original series of 26 cases was published in 1995. The same series has now expanded to 37 cases, which form the basis of this follow-up study. In contrast to the original series we found a high spontaneous extrusion rate (68 per cent) and in 27 per cent of cases complications necessitated removal of the subannular T tube. In favour of the technique was a low perforation rate after extrusion or removal (eight per cent). Although only nine per cent underwent re-ventilation this is unlikely to represent resolution of the middle ear effusion in the remaining cases.

We conclude that the adverse effects of the subannular tympanotomy technique for long-term ventilation of the middle ear outweigh the benefits when compared with the traditional technique of placing a T tube through a myringotomy incision.