INTRODUCTION: Acute otitis media (AOM) and otitis media with effusion (OME) are common in children, often leading to hearing loss and developmental delay. Ventilation tubes (VTs) manage persistent middle ear effusions by draining fluid and reducing pressure, which can decrease AOM recurrence. METHODOLOGY: This retrospective cohort study reviewed the medical records of 388 pediatric patients at King Faisal Medical Complex, Saudi Arabia, from August 2021 to February 2024. Data on demographics, tympanometry results, treatment outcomes, and surgical interventions were collected. The data was analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019
IBM Corp., Armonk, New York, United States). Categorical variables were reported as numbers and percentages, with descriptive statistics applied. RESULTS: Among 388 children aged 2 to 12 years, girls predominated (56.2%). Tympanometry revealed bilateral type B in 64.4% and unilateral type B in 35.6%. After three months of observation and treatment, 47.6% were relieved, while 52.4% had persistent type B. Most cases were newly diagnosed (95.07%). Adenoid enlargement was observed in 86.70%, allergic rhinitis in 92.61%, and adeno-tonsillar enlargement in 68.47%. Surgical interventions included myringotomy only (15.27%), myringotomy with Shah tube (46.31%), and Shepard tube (38.42%). Complications were rare, with 88.18% achieving complete symptom relief and 4.93% partial relief during postoperative follow-up at 2 weeks, 3 months, 6 months, and 12 months. CONCLUSION: VT effectively manages AOM and OME in children, with high rates of symptom relief. However, careful consideration of risks and follow-up is essential to optimize outcomes.