J Korean Med Sci.  2020 Apr;35(13):e83. 10.3346/jkms.2020.35.e83.

Analysis of Risk Factors for Myringosclerosis Formation after Ventilation Tube Insertion

• Kim EH
• Park KW
• Lee SH
• Kim BJ
• Park YH

• KMID: 2509605
• DOI: http://doi.org/10.3346/jkms.2020.35.e83

Abstract

Background
This study examined possible risk factors for myringosclerosis formation after ventilation tube insertion (VTI).
Methods
A retrospective study was performed in a single tertiary referral center. A total of 582 patients who underwent VTI were enrolled in this study. Patients were divided into two groups based on the presence or absence of myringosclerosis: MS+ and MS−. Characteristics of patients were collected through medical chart review; these included age, gender, nature and duration of effusion, type of ventilation tube (VT), duration and frequency of VTI, incidence of post-VTI infection, incidence of intraoperative bleeding, and presence of postoperative perforation. Incidences of risk factors for myringosclerosis and the severity of myringosclerosis in association with possible risk factors were analyzed.
Results
Myringosclerosis developed in 168 of 582 patients (28.9%) after VTI. Patients in the MS+ group had an older mean age than those in the MS− group. The rates of myringosclerosis were higher in patients with older age, serous otitis media, type 2 VT, post-VTI perforation, and frequent VTI. However, there were no differences in occurrence of myringosclerosis based on gender, duration of effusion, duration of VT placement, incidence of post-VTI infection, or incidence of intraoperative bleeding. The severity of myringosclerosis was associated with the duration of effusion and frequency of VTI.
Conclusion
Older age, serous effusion, type 2 VT, presence of post-VTI perforation, and frequent VTI may be risk factors for myringosclerosis after VTI; the severity of myringosclerosis may vary based on the duration of effusion and frequency of VTI.

Keyword

Otitis Media; Myringosclerosis; Ventilation Tube; Middle Ear; Risk Factor

Figure

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  Fig. 1 Classification of grade of myringosclerosis based on the number of involved quadrants in the tympanic membrane. (A) Grade 1: one quadrant. (B) Grade 2: two quadrants. (C) Grade 3: three quadrants. (D) Grade 4: four quadrants.

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  Fig. 2 Myringosclerosis formation after ventilation tube insertion, stratified according to age group.MS+ = with myringosclerosis, MS− = without myringosclerosis.

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  Fig. 3 Comparison of myringosclerosis formation after ventilation tube insertion, stratified according to age (threshold at 6 years old).MS+ = with myringosclerosis, MS− = without myringosclerosis.

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  Fig. 4 Association between myringosclerosis severity after VTI depending on characteristics of ventilation tube insertion.VT = ventilation tube, VTI = ventilation tube insertion.*P < 0.05.

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