Ventilation tube removal: Does treatment affect perforation closure?

Objective: The study goal was to determine whether treatment of the tympanic membrane at the time of ventilation tube (VT) removal affects closure of the perforation. Study Design: We conducted a retrospective chart review and telephone follow-up of children who underwent VT removal from 1995 through 1998. Results: Among 109 patients (162 ears; 58% male), the mean age at VT removal was 6.7 years. Most VTs (59%) were T-tubes, and most (91%) were removed because of prolonged retention (mean 2.3 years). After VT removal, 111 ears (69%) received treatment, most commonly (44%) with 25% trichloroacetic acid (TCA). At the latest follow-up, 151 of the ears (93%) had healed without additional treatment. Treatment failure occurred more frequently in ears not initially treated with TCA (TCA 3% failure, other treatment 13%, no treatment 8%) and in ears with VTs removed because of otorrhea. Conclusions: Most perforations healed. TCA may promote closure, but a large randomized clinical trial is needed to eliminate physician bias. (Otolaryngol Head Neck Surg 2002;126:663-668.)