Permanent mastoid vent: a new treatment for persistent eustachian tube obstruction.

To date, there is no satisfactory treatment for persistent eustachian tube blockage or negative pressure in the middle ear. Conventional ventilation tubes are usually either occluded or extruded with time. A new treatment of percutaneous mastoid vent provides permanent ventilation to the middle ear cleft without putting a tube through the eardrum. A titanium tube is inserted through the skin into the mastoid antrum using the established technique of osseo-integration and hence becomes truly permanent. It can also be connected to a CPAP machine to re-inflate a collapsed eardrum. Initial trials consist of six vents inserted and followed up for 6-16 months. There was no sign of extrusion or a foreign body reaction. However, an inner Teflon tube is essential to keep the vent patent for permanent ventilation to the middle ear cleft.