The Management of Myringotomy Tubes in Pediatric Cochlear Implant Recipients

Objective: To investigate the impact of myringotomy tubes (MTs) on outcomes for pediatric cochlear implant (Cl) recipients. Design: Retrospective case-control chart review. Setting: Tertiary care pediatric hospital. Patients: Sixty-two patients received an MT before CI (mean [SD] age at initial Cl, 3.20 [2.45] years). Seventy-eight ears received CIs and MTs. Intervention: The MTs were removed and allowed to extrude before CI (59% [n = 46]) or kept in place until CI (41% [n=32]). Main Outcome Measures: Otorrhea, persistent tympanic membrane (TM) perforation, and need for additional procedures were recorded. Statistical analysis was performed with the Fisher exact test. Results: Forty cars (51%) required more than 1 set of MIs. Ten ears (22%) in which the MTs were removed before Cl required a separate MT after Cl compared with 6 ears (19%) in which the MTs remained in place until Cl (P=.78). The MTs that were present during CI were either removed with myringoplasty (31% [n =10]) or retained after surgery (69% [n =22]). All TMs in which the tubes were removed before or during CI healed. There were 3 persistent TM perforations that required surgical treatment. There were no cases of meningitis and no removals of CIs because of infection. Conclusions: Myringotomy tubes do not appear to adversely affect the final outcomes of pediatric Cl recipients and can be managed similarly to MTs in other otitis media prone children. They may be left in place in children who continue to experience recurrent acute otitis media or removed in children who no longer need them.