{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:48:56Z","timestamp":1786978136721,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,1]]},"abstract":"\n Objectives<\/jats:title>\n In 2001, we instituted a protocol for the removal of retained tympanostomy tubes, delaying elective removal until 2.5\u2009years after placement. It was hoped that this would decrease the number of surgeries without increasing the rate of permanent tympanic perforations compared to removal at 2\u2009years.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Protocol<\/jats:italic>\n : Fluoroplastic Armstrong beveled grommet tympanostomy tubes were placed by a single surgeon supervising the residents. The children were seen at 6\u2010month intervals after placement. Children with a retained tympanostomy tube(s) at 2\u2009years were seen again at 2.5\u2009years, and the retained tubes were removed under general anesthesia with patch application. All were evaluated 4\u2009weeks after surgery by otoscopy, otomicroscopy, behavioral audiometry, and tympanometry.\n Study<\/jats:italic>\n : A computerized collection of patient letters and operative reports was queried to identify children treated according to the protocol between 2001 and 2022. Those with examinations at 2\u2009years\u2009\u00b1\u20091\u2009month and 2.5\u2009years\u2009\u00b1\u20091\u2009month and complete follow\u2010up were included.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 3552 children with tympanostomy tubes, 497 (14%) underwent tube removal. One\u2010hundred and forty seven children fit the strict inclusion criteria. Among those with retained tubes at 2\u2009years, 67\/147 (46%) had lost any remaining tube or tubes at 2.5\u2009years and did not need surgery, 80\/147 (54%) required unilateral or bilateral tube removal, 9\/147 (6%) had a persistent perforation at 1\u2010year follow\u2010up, and 4\/147 children (3%) required tympanic re\u2010intubation after either spontaneous extrusion or removal and patching at 2.5\u2009years.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Delaying tympanostomy tube removal until 2.5\u2009years can cut the need for surgery in half with, an acceptable (6%) incidence of persistent perforations.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n \n Four case series\u2014historical control\n Laryngoscope<\/jats:italic>\n , 134:439\u2013442, 2024\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.30751","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T07:19:40Z","timestamp":1684480780000},"page":"439-442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Elective Tympanostomy Tube Removal at 2.5\u2009Years: Results of a Protocol for Retained Tubes"],"prefix":"10.1002","volume":"134","author":[{"given":"Noah J.","family":"Thornton","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Lewis Katz School of Medicine at Temple University Philadelphia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-1796","authenticated-orcid":false,"given":"Glenn","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Lewis Katz School of Medicine at Temple University Philadelphia 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