This Italian study looked at the success rates of a novel method to manage adhesive otitis media (chronic otitis media with adhesion of the tympanic membrane to the promontory). The authors looked at 22 patients with unilateral chronic adhesive otitis media. All these patients underwent insertion of a silastic disk (6mm in diameter with a T-tube inserted in the centre) in the posterior inferior tympanic membrane between the annulus and bony wall of the middle ear. The mean improvement in air-bone gap at two years was 17.4dB, with 81.8% of patients achieving a satisfactory auditory outcome at two years (as defined by an improvement in the air-bone gap of >10dB). Only one patient had extrusion of the T-tube with residual perforation at two years. There are limited numbers in this study, and there is no comparison with other methods used to treat adhesive otitis media such as cartilage tympanoplasty. Nonetheless, this provides an interesting pilot study as to the effective of subannular T-tubes with silastic for the treatment of adhesive otitis media.

Subannular T-tubes for the treatment of adhesive otitis: how we do it?
Galletti B, Galletti F.
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Sunil Sharma

Alder Hey Children's Hospital, UK.

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