The management of myringotomy tubes in pediatric cochlear implant recipients

Arch Otolaryngol Head Neck Surg. 2010 Jun;136(6):557-60. doi: 10.1001/archoto.2010.80.

Abstract

Objective: To investigate the impact of myringotomy tubes (MTs) on outcomes for pediatric cochlear implant (CI) recipients.

Design: Retrospective case-control chart review.

Setting: Tertiary care pediatric hospital.

Patients: Sixty-two patients received an MT before CI (mean [SD] age at initial CI, 3.20 [2.45] years). Seventy-eight ears received CIs and MTs.

Intervention: The MTs were removed and allowed to extrude before CI (59% [n = 46]) or kept in place until CI (41% [n = 32]).

Main outcome measures: Otorrhea, persistent tympanic membrane (TM) perforation, and need for additional procedures were recorded. Statistical analysis was performed with the Fisher exact test.

Results: Forty ears (51%) required more than 1 set of MTs. Ten ears (22%) in which the MTs were removed before CI required a separate MT after CI compared with 6 ears (19%) in which the MTs remained in place until CI (P = .78). The MTs that were present during CI were either removed with myringoplasty (31% [n = 10]) or retained after surgery (69% [n = 22]). All TMs in which the tubes were removed before or during CI healed. There were 3 persistent TM perforations that required surgical treatment. There were no cases of meningitis and no removals of CIs because of infection.

Conclusions: Myringotomy tubes do not appear to adversely affect the final outcomes of pediatric CI recipients and can be managed similarly to MTs in other otitis media-prone children. They may be left in place in children who continue to experience recurrent acute otitis media or removed in children who no longer need them.

MeSH terms

  • Cerebrospinal Fluid Otorrhea / etiology
  • Child, Preschool
  • Cochlear Implantation
  • Cochlear Implants*
  • Female
  • Humans
  • Male
  • Middle Ear Ventilation* / adverse effects
  • Myringoplasty
  • Otitis Media / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Tympanic Membrane Perforation / etiology