Case Report: Dislocation of a self-cutting ventilation tube into the tuba auditiva.

Introduction A ventilation tube (VT) serves as a passive implant to optimize middle ear ventilation. Manufacturers offer different designs of VT. Self-cutting tubes are being increasingly chosen for outpatients treatment.

Medical history A 56-year-old patient presented after referral by a resident colleague with suspected VT dislocation. The VT insertion (Minimal tympanic tube Benz, Kurz^®) was performed on the right ear one week before by a otolaryngologist in outpatient care. The patient suffered from of a known tube dysfunction with tympanic effusion. Prior to this, a paracentesis had been performed 3 times within 4 weeks due to an acute otitis media. An atrophic eardrum had already been known for many years.

Results The medical examinations revealed a strongly atrophic and flaccid but intact eardrum on the right side. The pure-tone audiometry showed a combined hearing loss on the right side with normacusis on the left side. A computer tomography of the petrous bone showed on the right side the dislocation of the VT into the tuba auditiva with direct contact to the arteria carotis interna (distance to the ostium tympanicum tubae auditivae 6.3 mm). Surgical removal was performed with a combined microscopic and endoscopic approach via retroauricular incision with simultaneous stabilization of the eardrum. Six months post-operative, the hearing ability in the pure tone and speech audiometry was equal to the preoperative exams.

Conclusions Patients with known atrophic and flaccid eardrum should be informed about the potential risk of tube dislocation, especially when using self-cutting VT. If the clinical finding indicate it, we recommend using blunt VT (e.g. Tübingen type ventilation tubes).

Poster-PDF A-1522.pdf

Publication History

Article published online:
13 May 2021