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Ventilation tube non-function due to blockage in children: the frequency, course and effect on hearing. A prospective cohort study

Published online by Cambridge University Press:  04 December 2020

M Merven ,
J W Loock  and
G G Browning
M Merven*
Affiliation:
Department of Otorhinolaryngology, Tygerberg Hospital, Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa
J W Loock
Affiliation:
Department of Otorhinolaryngology, Tygerberg Hospital, Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa
G G Browning
Affiliation:
Otorhinolaryngology and Head and Neck Surgery, University of Glasgow, Scotland, UK, affiliated with Medical Research Council/Chief Scientist Office (‘MRC/CSO’) Institute of Hearing Research, Glasgow, Scotland, UK
*
Author for correspondence: Dr Marc Merven, Division of ENT Surgery (Otorhinolaryngology), Tygerberg Hospital, Faculty of Health Sciences, University of Stellenbosch, Francie Van Zyl Street, Cape Town, South Africa E-mail: marcmerven@sun.ac.za
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Abstract

Objective

To assess the effect on hearing of non-functioning ventilation tubes due to blockage during the first six months post-operatively, using UK national guidelines.

Method

A prospective, observational study was conducted on 37 children who underwent bilateral ventilation tube insertion. Air and bone conduction thresholds were measured before and following surgery, and at one, three and six months post-operatively. Tube non-function was assessed by tympanometry supported by otoscopy.

Results

Post-operatively, an average of 21 per cent of ventilation tubes were non-functioning. Ears with non-functioning tubes had significantly (p = 0.0001) poorer mean air conduction thresholds than functioning tubes, with a magnitude of 6 dB HL. Ears with otorrhoea were most affected (15 per cent). At any one visit, the air–bone gap was closed to 10 dB or less in 76 per cent of ears. Non-functioning tubes reduced this to 56 per cent. Compared with tympanometry, otoscopy underdiagnosed tube non-function due to blockage by 22 per cent.

Conclusion

Non-functioning of ventilation tubes occurs frequently and can be missed on otoscopy. Although it is associated with poorer air conduction thresholds, the magnitude of this difference is unlikely to warrant further intervention unless there is otorrhoea or recurrence of bilateral hearing impairment.

Keywords

Middle Ear VentilationGrommet InsertionPatencyHearing OutcomeMiddle Ear EffusionOtitis Media With Effusion
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 12 , December 2020 , pp. 1052 - 1059
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr M Merven takes responsibility for the integrity of the content of the paper

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