: to estimate a period for grommet tube removal
in the age category of 4-8 years that is associated with the
highest rate of success and the least rate of recurrence. Design:
prospective randomised study Setting: Benha University
Hospital and 3 private clinics. Patients: 500 children, 4-8 years
old, diagnosed as having chronic SOM managed by Shapered
grommet tubes insertion, were randomly allocated into 4
groups according to the planned timing of tube removal; after
6 months (group A), 12 months (group B), 18 months (group
C) and 24 months (group D). Patients were followed-up for 18
months after tube removal. Main outcome measures: middle
ear pressure, perforation healing time, hearing improvement
and recurrence, in relation to time of tube removal Results:
541 ears in 316 children were analysed. Group A showed
higher rate of recurrence of SOM after 18 months post-tube
removal while it showed low residual perforation rate. Group
C and D showed higher residual perforation rates comparing to
the other groups at the end of the follow up period. Recurrence
of SOM was minimal in group C and D. Group B showed
low rate of recurrence comparable to group C and D and also
showed low rate of residual perforation comparable to group
A. Conclusions: Removing grommet tubes by the 12th month
postoperative is recommended in cases of secretory otitis media
in the age group of 4-8 years as it achieved low recurrence rate
of SOM and low residual perforation rate compared to earlier
or later removal. |
