Comparison of tympanostomy tube insertion with and without radiofrequency ablation eustachian tuboplasty for treating chronic otitis media with effusion

Abstract

Objective

The objective of this study was to compare the effect and complication of tympanostomy tube insertion (TTI) alone and radiofrequency ablation (RFA) tuboplasty combined with TTI for the treatment of chronic otitis media with effusion (COME) with chronic eustachian tube dysfunction (CETD) in adult.

Material and methods

The patients with COME and CETD who met the inclusion criteria were allocated to TTI alone group and TTI + RFA tuboplasty group. Primary outcomes were tube retention success and total ETDQ-7score. Secondary outcomes were TT premature extrusion, recurrence, hearing improvement, perforation closure, and complications.

Results

The Tube retention success rates were 78.6 % in the TTI alone group and 95.2 % in the TTI + RFA group (P < 0.05). Postoperative 6 months total ETDQ-7 score was significantly reduced in the TTI alone group and TTI + RFA group, whereas the total score in the TTI + RFA group was significantly lower than that in the TTI alone group (P < 0.05). The TT premature extrusion rates were 21.4 % in the TTI alone group and 4.7 % in the TTI + RFA group (P < 0.05). The OME recurrence rates in the TTI alone was significantly higher than that in the TTI + RFA group (21.4 % vs 2.4 %, P < 0.05). Postoperative ET inflammation scale or IT hypertrophy grading significantly decreased in TTI + RFA groups (P < 0.001), whereas scale in the TTI alone group had no significant change (P = 0.065). The complete aeration of the middle ear and mastoid rates in the TTI + RFA group was significantly higher than that in the TTI alone group after a followup period of 12 months (P = 0.040). Stenosis/scar of anterior-post wall in the ET orifice was seen in 3 patients in the TTI + RFA group.

Conclusions

TTI combined with RFA tuboplasty is effective and safe for COME in adult. Compared with simple TTI, application of RFA tuboplasty can effectively improve the tube retention and reduce the OME recurrence.