Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1592
Peer-review started: December 16, 2019
First decision: February 20, 2020
Revised: March 4, 2020
Accepted: April 15, 2020
Article in press: April 15, 2020
Published online: May 6, 2020
Processing time: 135 Days and 22.3 Hours
Although long-term retention of a ventilation tube is required in many ear diseases, spontaneous removal of conventional ventilation tube is observed in patients within 3 to 12 mo. To address this issue, we aimed to determine a new method for long-term retention of the ventilation tube.
To explore the value of removing the biofilm for long-term retention of tympanostomy ventilation tubes.
A case-control study design was used to evaluate the safety and effectiveness of long-term tube retention by directly removing the biofilm (via surgical exfoliation) in patients who underwent myringotomy with ventilation tube placement. The patients were randomly divided into two groups: Control group and treatment group. Patients in the treatment group underwent regular biofilm exfoliation surgery in the clinic, whereas those in the control group did not have their biofilm removed. Only conventional ventilation tubes were placed in this study. Outcome measures were tube position and patency. Tube retention time and any complications were documented.
Eight patients with biofilm removal and eight patients without biofilm removal as a control group were enrolled in the study. The tympanostomy tube retention time was significantly longer in the treatment group (43.5 ± 26.4 mo) than in the control group (9.5 ± 6.9 mo) (P = 0.003). More tympanostomy tubes were found to be patent and in correct position in the treatment group during the follow-up intervals than in the control group (P = 0.01).
Despite the use of short-term ventilation tubes, direct biofilm removal can be a well-tolerated and effective treatment for long-term tube retention of tympanostomy ventilation tubes in patients who underwent myringotomy.
Core tip: Long-term ventilation tube retention is necessary in many diseases, such as refractory otitis media with effusion and eustachian tube dysfunction, as well as with the use of Meniett therapy for Ménière disease. However, conventional ventilation tubes are expelled spontaneously within 3 to 12 mo because of tube extrusion or obstruction. Therefore, patients have to undergo two or more myringotomy with ventilation tube placement procedures, along with the risks of anesthesia and surgery, excessive injury to the tympanic membrane and external auditory canal, medical care costs, and impact on school or work. The biofilm plays a crucial role in the development of extrusion or obstruction after myringotomy with ventilation tube placement. It was revealed that, despite the use of short-term tube, biofilm removal has been proven to be a safe and effective treatment for long-term tube retention.