Abstract
Although the precise mechanism of ventilating tube extrusion from the tympanic membrane is undetermined, it has often been attributed to epithelial migration. However, there has been no experimental evidence for such a hypothesis. In this study, epithelial migration was examined on 28 human tympanic membranes in which ventilating tubes had been inserted. It was found that the presence of such tubes did not alter the pattern of migration. It appears unlikely that epithelial migration alone is responsible for the extrusion process. A mechanism for ventilating tube expulsion is proposed which is compatible with clinical and experimental findings.

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