{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:54:32Z","timestamp":1792788872413,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"vor","delay-in-days":5632,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2001,4]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To estimate the incidence of tympanostomy tube sequelae based on systematic review of published case series and randomized studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>DATA SOURCES<\/jats:title><jats:p>English\u2010language MEDLINE search from 1966 through April 1999 with manual reference search of proceedings, articles, reports, and guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY SELECTION<\/jats:title><jats:p>Cohort studies with otitis media as the primary indication for tube placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>DATA EXTRACTION<\/jats:title><jats:p>Two reviewers independently extracted data from 134 articles.<\/jats:p><\/jats:sec><jats:sec><jats:title>DATA SYNTHESIS<\/jats:title><jats:p>Transient otorrhea occurred in 16% of patients in the postoperative period and later in 26%; recurrent otorrhea occurred in 7.4% of patients and chronic otorrhea in 3.8%. Sequelae of indwelling tubes included obstruction (7% of ears), granulation tissue (5%), premature extrusion (3.9%), and medial displacement (0.5%). Sequelae after tube extrusion included tympanosclerosis (32%), focal atrophy (25%), retraction pocket (3.1%), cholesteatoma (0.7%), and perforation (2.2% with short\u2010term tubes, 16.6% with long\u2010term tubes). Meta\u2010analysis showed that long\u2010term tubes increased the relative risk of perforation by 3.5 (95% CI, 1.5 to 7.1) and cholesteatoma by 2.6 (95% CI, 1.5 to 4.4). Similarly, intubation increased the relative risk of tympanosclerosis by 3.5 (95% CI, 2.6 to 4.9) and focal atrophy by 1.7 (95% CI, 1.1 to 2.7) over nonintubated control ears (baseline tympanosclerosis and atrophy rates of 10% and 14%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Sequelae of tympanostomy tubes are common but are generally transient (otorrhea) or cosmetic (tympanosclerosis, focal atrophy). Nonetheless, the high incidence suggests a need for ongoing otologic surveillance of all patients with indwelling tubes and for a reasonable time period after tube extrusion. Long\u2010term tubes should be used on a selective and individualized basis.<\/jats:p><\/jats:sec>","DOI":"10.1067\/mhn.2001.113941","type":"journal-article","created":{"date-parts":[[2003,2,4]],"date-time":"2003-02-04T21:49:09Z","timestamp":1044395349000},"page":"374-380","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":391,"title":["Meta\u2010Analysis of Tympanostomy Tube Sequelae"],"prefix":"10.1002","volume":"124","author":[{"given":"David J.","family":"Kay","sequence":"first","affiliation":[{"name":"Department of Otolaryngology SUNY Health Science Center at Brooklyn Brooklyn New York"},{"name":"The Long Island College Hospital Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magalie","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology SUNY Health Science Center at Brooklyn Brooklyn New York"},{"name":"The Long Island College Hospital Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Rosenfeld","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology SUNY Health Science Center at Brooklyn Brooklyn New York"},{"name":"The Long Island College Hospital Brooklyn New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9]]},"reference":[{"key":"e_1_2_4_2_1","first-page":"13","volume-title":"Ambulatory and inpatient procedures in the United States, 1996. 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