Time‐to‐Event Comparison of Two Surgical Techniques for Excision of Localised Pars Tensa Retraction

Introduction We investigate whether the insertion of a ventilation tube into the tympanic membrane affects the healing of the tympanic membrane after excision of clinically significant pars tensa retraction. Methods A retrospective analysis of patients with pars tensa retraction who underwent surgical excision of the retracted part of their tympanic membrane without surgical repair of the defect. Time to event analysis was used to compare perforation closure of the group who underwent ancillary ventilation tube insertion to that of the group with retraction excision alone. Results Eligible were 149 ears from 149 patients with a median age of 11 years ( IQR : 8–21 years), where 47 underwent excision only and 102 underwent excision plus tube insertion. At 6 months after surgery, a higher percentage of patients who underwent excision alone healed (89%) compared to those who had excision with tube insertion (75%). The depth of the retraction pocket and the integrity of the ossicular chain were also independently associated with the tympanic membrane closure. Age, sex, side of ear surgery and location of retraction were not associated with this outcome. At 6 months, the probability that the difference between the two surgical groups is due to chance is 0.004. Conclusion In our series, ancillary ventilation tube insertion had a detrimental effect on the complete spontaneous healing of the tympanic membrane after retraction pocket excision without surgical repair of the defect.