Comparison of four ventilation tubes commonly used in the pediatric population: A retrospective cohort study.

ABSTRACT

Objective: To assess differences in otorrhea, tympanic membrane perforation, and time to extrusion in children receiving one of four commonly used, short-term ventilation tubes for the first time. Methods: Retrospective chart review of 2 years of postoperative follow-up to analyze patient outcomes after insertion of either a Paparella type-I Activent, Armstrong Beveled, Modified Armstrong, or Armstrong Microgel ventilation tube. Incidence of complications was determined by reviewing provider notes. Adjusted multivariate logistic regression models were used to determine odds ratios of complications among the four tube types. Results: A total of 387 patients were reviewed. The mean age was 2.4 years and 35.9% were female. Armstrong beveled tubes had the highest odds of otorrhea. Paparella type-I tube had the shortest time to extrusion of about 9 months, while Armstrong Beveled had the longest, at almost 19 months. When evaluating episodes of otorrhea each child experienced on average, per month, Armstrong beveled tubes had the highest monthly rate of otorrhea and Paparella type-I the least. No significant differences were found regarding tympanic membrane perforation. Conclusions: This retrospective chart review showed that no tube was clinically superior across all complications. The findings from this study may give otolaryngologists an opportunity to consider choosing a specific type of tube according to the clinical situation. The large variations in extrusion times should be considered in terms of patient age, seasonality, and desired duration of tube placement. Level of Evidence 4.