Comparison of characteristics of titanium and fluoroplastic ventilation tubes in adults with healthy middle ears.

Introduction: Most clinical studies on adverse effects and extrusion rates of tympanostomy tubes have been conducted with children undergoing treatment because of recurrent acute otitis media or chronic otitis media with effusion. Little is known, however, about post tympanostomy complications and extrusion rates in healthy middle ears. In this study, we analyzed extrusion rates and adverse effects of fluoroplastic, titanium, and gold ventilation tubes of different sizes in adult patients with Ménière's disease.

Methods: Clinical record study including 108 patients.

Results: Otorrhea occurred in 18% of fluoroplastic tubes but only 4% of titanium tubes. Permanent occlusion was observed in 22% of fluorplastic but only 4% of titanium tubes. No statistical difference was seen for transient dysfunction and tube extrusion rates. Granulations and chronic perforations were not observed.

Discussion: The low rate of infections and permanent occlusions for titanium tubes as well as the lack of granulations and chronic perforations for all tubes might be due to the fact that our patients were adults with healthy middle ears. Furthermore, a better biocompatibility of titanium in the middle ear compared with gold or synthetic materials has been observed for protheses used to rebuild the sound conductive apparatus of the middle ear.

Conclusion: Titanium tubes might be the better choice for adult patients lacking Eustachian tube dysfunction and otitis media with effusion. Ventilation tubes in adults with healthy middle ears seem to be less associated with adverse effects compared with ventilation tubes in children with otitis media with effusion or recurrent otitis media.