The prevention of tympanic membrane perforation following the removal of long-term Paparella type II ventilation tubes.

Residual perforation following the extrusion or removal of a long-term ventilation tube may occur in between 8.5% and 25% of cases. This prospective clinical trial concerns Paparella II ventilation tubes and demonstrated that (a) extracting (pulling) a tube from the tympanic membrane gives a 6-month perforation rate of 20%, (b) excising (freshening) the edge of the defect at the time of removal decreases the 6-month perforation rate to 3%, and (c) excising the edge significantly accelerates the healing of the tympanic membrane. There was no correlation in this study between the incidence of perforation and age, sex, ear affected, tympanosclerosis, ventilation tube position, tube in situ time or discharge. The study confirmed a high rate of tympanosclerosis (76%) to be associated with ventilation tubes. Long-term discharge (68%) was identified as a problem of Paparella II ventilation tubes.