Second Sets of Tympanostomy Tubes Extrude Sooner

Abstract

Introduction: Some clinicians believe second sets of tympanostomy tubes extrude more quickly than first sets.

Study design: Retrospective case-control series.

Methods: We identified children who were examined 12 months after placement of their second set of tympanostomy tubes and compared them to a similar number of children who were examined 12 months after their first set of tympanostomy tubes. Extrusion was determined by otoscopy, otomicroscopy, and/or tympanometry.

Results: One hundred eighteen children had 12-month follow-up data available after their first set of tubes, 54 had 12-month follow-up data available for their second set, and 56 had 12-month follow-up data after their first and second sets. A total of 568 tubes were observed. Looking at each tube, second set tubes were significantly more likely to be extruded at 12 months (48%) compared to first set (28%) (P < .001). Patient age was not associated with extrusion rate. For patients who had 12-month follow-up for both their first and second set of tubes, there was no correlation between extrusion of first and second set tubes.

Conclusion: Second set tympanostomy tubes are significantly less likely to remain functional 12 months after placement than first sets, independent of patient age at placement and independent of whether the child's first tubes extruded by 12 months. Given the short duration of second tube function, delaying second set placement until the fall might be a better choice for some children.

Level of evidence: 3 Laryngoscope, 132:222-224, 2022.

Keywords: Myringotomy tube; extrusion; otitis media; tympanostomy tube.