Survival and Outcomes of Type I Ventilation Tubes Insertion in Adult Adhesive Otitis Media: A Longitudinal Analysis

OBJECTIVE: To characterize short- and mid-term outcomes of standard type I ventilation tube insertion (VTI) in adults with adhesive otitis media (AdOM). STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary referral center. PATIENTS: Adults with AdOM graded by Sade classification who underwent type I transtympanic VTI (n=23, 30 ears). INTERVENTION: Type I transtympanic VTI (Paparella type I, Medtronic). MAIN OUTCOME MEASURES: Four-frequency pure-tone average (PTA₄) and air-bone gap (ABG) at 1 month; tympanic membrane (TM) stage change (Sade classification) at 1 month; tube retention (Kaplan-Meier); and post-extrusion TM sequelae at 12 months. RESULTS: At 1 month, mean PTA₄ improved from 29.04±17.06 to 21.71±17.04 dB HL and mean ABG improved from 14.17±11.96 to 7.38±9.65 dB HL (both P<0.001). TM morphology improved as stage 0 increased to 66.7% and stages 3-4 decreased to 13.3% (P<0.001). Tube retention was 57% at 6 months and 20% at 12 months; retraction recurrence (53.3%) and persistent TM perforation (13.3%) were observed. CONCLUSION: Type I VTI in adult AdOM yields short-term auditory and structural improvements but limited 1-year durability, with frequent recurrence after extrusion.