Tympanostomy Tube Placement: The Effect of Location on Tube Retention and Risk of Perforation.

Authors

Jason G May, Eric Y Du, Jacob A Thoenen, Eliav Gov-Ari, Arnaldo L Rivera

Published in

Laryngoscope investigative otolaryngology. Volume 11. Issue 5. Pages e70590. Epub Oct 09, 2026.

Abstract

The retrospective cohort study compares tube location in the anterior-inferior quadrant versus the posterior-inferior quadrant and time of tube retention along with the risk of early extrusion and perforation. The study hypothesis holds that both anterior-inferior placement and posterior-inferior placement are equally effective and safe locations for tube placement with equal tube retention and risk for tympanic membrane perforation.
An IRB-approved retrospective chart review was completed at a major Academic Center's Children's Hospital. The study included data from children who underwent tube placement between 6 months and 16 years old between February 2019-February 2021. Demographics and clinical factors were collected.
Of the 905 patients and 1800 ears, a total of 1584 ears had tubes placed in the anterior-inferior quadrant and 216 were placed in the posterior-inferior quadrant. Tubes remained in place for 487 days in the anterior-inferior quadrant and 456 in the posterior-inferior quadrant. The risk of perforation was 1.4% in the anterior-inferior quadrant and 0% in our study for the posterior-inferior quadrant. Univariate analysis showed a difference but was not significantly different (1.10 [0.95, 1.27]). This slight difference was confirmed by multivariate analysis HR = 1.11 [0.96, 1.30].
This study shows that there is no difference in tube retention or risk of tympanic membrane perforation based on location of tympanostomy tube placement either in the anterior-inferior quadrant versus the posterior-inferior quadrant. Factors associated with earlier tube extrusion included older age, cleft palate, and recurrent acute otitis media as the diagnosis. T-tubes had slower extrusion, as expected.
3.

PMID:
42859552
Bibliographic data and abstract were imported from PubMed on 11 Oct 2026.

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