Articoli di riviste: "Tympanostomy tube insertion"

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Whelan, Rachel L., e Raymond C. Maguire. "Tympanostomy Tube Innovation: Advances in Device Material, Design, and Office-Based Technology". Ear, Nose & Throat Journal 99, n. 1_suppl (2 giugno 2020): 48S—50S. http://dx.doi.org/10.1177/0145561320924910.

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Objectives: With tympanostomy tube insertion remaining the most common procedure performed in children to date, growing interests in minimizing both procedural costs and anesthetic exposure in the pediatric population have inspired innovation with respect to tympanostomy tubes. As such, we aim to discuss the current state of tympanostomy tube innovation including insertion devices, tube material, and design. Methods: Computerized literature review. Results: (1) Numerous single-use devices consisting of a myringotomy knife and preloaded tympanostomy tube offer potential advantages of decreasing or eliminating operating room time and may be performed under moderate instead of a general anesthetic. (2) Innovation with respect to tympanostomy tube material and design may offer enhanced ototopical drug delivery, decreased rates of tube occlusion, and/or the ability to dissolve “on-command” with application of a novel ototopical material. (3) These technologies currently remain in various phases of preclinical and clinical testing. Conclusions: While clinical testing for a number of new technologies is preliminary and ongoing, tympanostomy tube-related innovations hold exciting promise to supplement or potentially replace the present-day armamentarium of tympanostomy tube design and insertion moving forward.

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Tuaño-Uy, Melita Jesusa Suga, e Norberto V. Martinez. "Model Myringotomy Practice Set: A do-it-yourself and inexpensive alternative". Philippine Journal of Otolaryngology-Head and Neck Surgery 23, n. 1 (30 giugno 2008): 31–34. http://dx.doi.org/10.32412/pjohns.v23i1.771.

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Objective: To develop a simple, portable, inexpensive model for otolaryngology trainees to practice on and develop skills required for myringotomy and tympanostomy tube insertion. Materials and Methods: Recycled plastic egg crate, a 3-cc plastic syringe, micropore™ tape and modeling clay were used to create a model to practice myringotomy and tympanostomy tube insertion utilizing tubes fashioned from a recycled 18 guage intravenous catheter. Result: The model myringotomy practice set is an inexpensive, simple do-it-yourself device made of locally available, mostly recycled materials. Key words: myringotomy practice set, myringotomy, middle ear ventilation, tympanostomy, tympanostomy tube insertion, instrumentation

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Hajiioannou, J. K., S. Bathala e C. N. Marnane. "Case of perilymphatic fistula caused by medially displaced tympanostomy tube". Journal of Laryngology & Otology 123, n. 8 (agosto 2009): 928–30. http://dx.doi.org/10.1017/s0022215108003873.

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AbstractObjective:We present a rare case of perilymphatic fistula which occurred due to bony erosion by a tympanostomy tube that had migrated into and become interred in the middle-ear space.Method:We present a case report and a literature review concerning migration of tympanostomy tubes into the middle ear as a complication of tubes insertion.Conclusion:Medial migration of tympanostomy tubes into the middle-ear space is a rare complication of tympanostomy tubes insertion. To our knowledge, this is the first report of perilymphatic fistula caused by a tympanostomy tube which had migrated into the middle ear. This case highlights the need for early removal of tympanostomy tubes which migrate into the middle ear.

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Cheng, Jeremiah, David Cheng, Cheng Rebecca e Chen Timothy. "S115 – A New Treatment for Post-tympanostomy Tube Otorrhea". Otolaryngology–Head and Neck Surgery 139, n. 2_suppl (agosto 2008): P115—P116. http://dx.doi.org/10.1016/j.otohns.2008.05.288.

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Objectives To discover whether tubes coated with antibiotic ointment can prevent the complication of post-tympanostomy tube otorrhea. Methods Retrospective chart analysis was done of the last 344 consecutive ears for tube surgery without ointment, and tube surgery with ointment, from Dec. 2006 to Oct. 2007. Only surgery using 7mm flouroplastic tubes were reviewed. Results A total of 128 ears had no ointment during the operation. Of the 128 ears, 12 ears developed otorrhea within 1 week, or an incidence of 9.4%. A total of 216 ears had antibiotic ointment coated onto the fluoroplastic tube during the operation and at time of tube insertion. Of the 216 ears, 7 ears developed post-tympanostomy tube otorrhea within 1 week, or an incidence of 3.2%. Our analysis using the chi-square test was statistically significant, with a p value of 0.02. Conclusions Post-tympanostomy tube otorrhea is a frequent complication of tympanostomy tube insertion, but by coating the tube with an antibiotic ointment at the time of surgery, we can decrease that incidence from 9.3% to 3.2%.

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Valtonen, Hannu, Yrjö Qvarnberg e Juhani Nuutinen. "Tympanostomy in young children with recurrent otitis media. A long-term follow-up study". Journal of Laryngology & Otology 113, n. 3 (marzo 1999): 207–11. http://dx.doi.org/10.1017/s0022215100143592.

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AbstractA total of 305 children, five to 16 months of age, were treated from 1983–1984 with ventilation tubes – Shah vent Teflon tube – inserted under local anaesthesia for recurrent acute otitis media (RAOM) or otitis media with effusion (OME). The final study group comprised 281 children (92.1 per cent) monitored prospectively for five years, 185 in the OME-group and 96 in the RAOM-group. For the first insertion of tubes the average ventilation period was 15.4 months. Re-tympanostomy, with adenoidectomy simultaneously at the first time was performed in 99 ears (35.2 per cent); once in 27.0 per cent, twice in five per cent, and three times in 3.2 per cent. Mastoidectomy due to otorrhoea was performed in three ears (1.1 per cent). The children in the OME-group were at higher risk of repeated post-tympanostomy otorrhoea episodes than children in the RAOM-group. These episodes of otorrhoea during the first insertion of ventilation tubes significantly increased both the tube extrusion rate and the need for subsequent re-tympanostomies. No major complications were caused by the tympanostomy procedure as such. It is concluded that early tympanostomy is a safe procedure in young children with RAOM or OME. However, parents should be carefully informed of risks of post-tympanostomy otorrhoea and recurrent disease after insertion of ventilation tubes necessitating subsequent tube insertion, especially in children with OME.

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Aguila, Konrad P. "Self-Retaining Harpoon Tympanostomy Tube with Applicator". Philippine Journal of Otolaryngology-Head and Neck Surgery 22, n. 1-2 (28 novembre 2007): 27–30. http://dx.doi.org/10.32412/pjohns.v22i1-2.797.

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Objective: To describe a novel harpoon design for a low cost, self retaining tympanostomy tube with applicator used in a 38-year-old female for otitis media with effusion. Methods: Study design: Instrumental Innovation/Case Report Setting: Tertiary Hospital in Metro Manila Results: The tympanostomy tube was inserted under endoscopic guidance within 10 seconds, remained in place for two months with relief of symptoms, and spontaneously extruded by the seventh month of follow-up. Conclusion: The harpoon-designed tube with applicator provided ease of insertion and good anchorage in the tympanic membrane. Maximizing the use of a stylet-needle as both perforator and applicator simplified the tympanostomy and ventilating tube insertion procedures into a single maneuver. Key words: middle ear ventilation, tympanostomy tube insertion, grommet insertion, instrumentation

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Cordes, Brett M., Nurupama Madduri e Ellen M. Friedman. "S252 – The Efficacy of Tympanostomy Tubes In Down Syndrome Patients". Otolaryngology–Head and Neck Surgery 139, n. 2_suppl (agosto 2008): P159. http://dx.doi.org/10.1016/j.otohns.2008.05.428.

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Objectives The purpose of this report is to relate a single institution's experience with middle ear disease and the incidence and efficacy of tympanostomy tube (PET) insertion in children with Down syndrome. Methods Retrospective chart review of 130 consecutive pediatric Down syndrome patients seen at a single tertiary care children's hospital between the years 2001–2007. Middle ear function, and speech and language development, is reported and those patients who underwent tympanostomy tube insertion for middle ear disease are analyzed. Results The mean age of the patient population was 4.5 years, ranging from 8 months to 10 years. 41/130 patients (31.5%) were treated with tympanostomy tube insertion for middle ear disease. Of this group, 11/41 patients (26.8%) and 2/11 patients (18.1%) required second and third tube insertions, respectively, for persistent pathology and failed tube function. The mean age at first tube insertion was 3.3 years, while the mean age at second and third tube insertion was 6.9 and 6.0 years. Outcome measures included a documented conductive hearing loss on audiological assessment and/or persistent middle ear effusion on physical exam. Speech and language skills were also assessed. Conclusions Children with Down syndrome have an increased incidence and persistence of middle ear disease. Additionally, affected children may require multiple surgical interventions for persistent disease and failed tube function. The multiple medical problems often associated with Down syndrome result in an increased anesthetic risk for these patients. Therefore, we propose the utility of a durable tympanostomy tube for more efficient treatment and the avoidance of multiple interventions.

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Zielnik-Jurkiewicz, Beata. "Drainage or paracentesis". Polski Przegląd Otorynolaryngologiczny 6, n. 2 (30 giugno 2017): 1–7. http://dx.doi.org/10.5604/01.3001.0010.0740.

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Tympanostomy tube insertion and tympanic membrane incision are two the most frequently performed surgical procedures in otolaryngology, especially in children. The tympanic membrane incision - paracentesis, or myringotomy – is an incision of the tympanic membrane for diagnostic purposes or to allow drainage of pathological secretion from the tympanic cavity. Tympanostomy tube insertion involves incision made in the tympanic membrane and insertion of a ventilation tube (various types and for various periods of time) to improve hearing and aeration of the tympanic cavity. Procedures are performed through the ear canal (transcanal approach), under local or general anesthesia. Complications may occur in some cases of paracentesis and tympanostomy tube insertion.

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Wang, Mao-Che, Ying-Piao Wang, Chia-Huei Chu, Tzong-Yang Tu, An-Suey Shiao e Pesus Chou. "Impact of Pneumococcal Conjugate Vaccine on Pediatric Tympanostomy Tube Insertion in Partial Immunized Population". Scientific World Journal 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/248678.

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Objective. To investigate the impact of seven-valent pneumococcal conjugate vaccine on tube insertions in a partial immunized pediatric population.Study Design. Retrospective ecological study.Methods. This study used Taiwan National Health Insurance Research Database for the period 2000–2009. Every child under 17 years old who received tubes during this 10-year period was identified and analyzed. The tube insertion rates in different age groups and the risk to receive tubes in different birth cohorts before and after the release of the vaccine in 2005 were compared.Results. The tube insertion rates for children under 17 years of age ranged from 21.6 to 31.9 for 100,000 persons/year. The tube insertion rate of children under 2 years old decreased significantly after 2005 in period effect analysis (β= −0.074,P< 0.05, and the negativeβvalue means a downward trend) and increased in children 2 to 9 years old throughout the study period (positiveβvalues which mean upward trends,P< 0.05). The rate of tube insertion was lower in 2004-2005 and 2006-2007 birth cohorts than that of 2002-2003 birth cohort (RR = 0.90 and 0.21, 95% CI 0.83–0.97 and 0.19–0.23, resp.).Conclusion. The seven-valent pneumococcal conjugate vaccine may reduce the risk of tube insertion for children of later birth cohorts. The vaccine may have the protective effect on tube insertions in a partial immunized pediatric population.

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Outhoff, Kim. "Grommets - an update on common indications for tympanostomy tube placement". South African Family Practice 59, n. 3 (10 luglio 2017): 13–16. http://dx.doi.org/10.4102/safp.v59i3.4684.

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Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalize pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old.1 By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent acute AOM, and acute otitis media that persists despite antibiotic therapy.2 However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1%–6%).3 This article offers guidance for family practitioners wishing to optimize health outcomes in children potentially requiring tympanostomy tube placement.

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Lona, Jacob A., F. B. Sloop, Austin Sydnor e Leigh G. Donowitz. "Bacteremia Associated with Tympanostomy Tube Insertion". Journal of Infectious Diseases 159, n. 3 (marzo 1989): 594–95. http://dx.doi.org/10.1093/infdis/159.3.594-a.

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April, Max M., Rafael R. Portella, Peter W. Orobello e Robert M. Naclerio. "Tympanostomy Tube Insertion: Anterosuperior vs. Anteroinferior Quadrant". Otolaryngology–Head and Neck Surgery 106, n. 3 (marzo 1992): 241–42. http://dx.doi.org/10.1177/019459989210600306.

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We studied the extrusion rate of Paparella type I tympanostomy tubes in the anterosuperior quadrant compared to those placed in the anteroinferior quadrant in a prospective study. Thirty-five patients were evaluated. The duration (mean ± SEM) in the anteroinferior quadrant was 211 ± 18 days, whereas the duration in the anterosuperior quadrant was 211 ± 11 days. We conclude that placement in the anterosuperior quadrant does not prolong duration of these tympanostomy tubes.

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Jang, C. H., H. Park, Y. B. Cho e C. H. Choi. "Effect of vancomycin-coated tympanostomy tubes on methicillin-resistant Staphylococcus aureus biofilm formation: in vitro study". Journal of Laryngology & Otology 124, n. 6 (8 gennaio 2010): 594–98. http://dx.doi.org/10.1017/s0022215109992672.

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AbstractBackground and objective:Bacterial biofilm formation has been implicated in the high incidence of persistent otorrhoea after tympanostomy tube insertion. It has been suggested that the tube material may be an important factor in the persistence of such otorrhoea. Development of methicillin-resistant Staphylococcus aureus otorrhoea after tympanostomy tube placement is a growing concern. We evaluated the effect of using vancomycin and chitosan coated tympanostomy tubes on the incidence of methicillin-resistant Staphylococcus aureus biofilm formation in vitro.Materials and methods:Three sets each of vancomycin-coated silicone tubes (n = 5), commercial silver oxide coated silicone tubes (n = 5) and uncoated tympanostomy tubes (as controls; n = 5) were compared as regards resistance to methicillin-resistant Staphylococcus aureus biofilm formation after in vitro incubation.Results:Scanning electron microscopy showed that the surfaces of the silver oxide coated tubes supported the formation of thick biofilms with crusts, comparable to the appearance of the uncoated tubes. In contrast, the surface of the vancomycin-coated tympanostomy tubes was virtually devoid of methicillin-resistant Staphylococcus aureus biofilm.Conclusion:Vancomycin-coated tympanostomy tubes resist methicillin-resistant Staphylococcus aureus biofilm formation. Pending further study, such tubes show promise in assisting the control of methicillin-resistant Staphylococcus aureus biofilm formation.

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Mui, Stanley, Barry M. Rasgon, Raymond L. Hilsinger, Brent Lewis e Gretchen Lactao. "Tympanostomy Tubes for Otitis Media: Quality-of-Life Improvement for Children and Parents". Ear, Nose & Throat Journal 84, n. 7 (luglio 2005): 418–24. http://dx.doi.org/10.1177/014556130508400712.

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We measured quality of life issues for both children and their parents on the premise that parental quality of life should be an aspect of cost-effectiveness in otitis media treatment. The patients were less than 18 years of age and had had myringotomy with tube insertion at the head and neck surgery department of a large health maintenance organization. Quality of life for patients, parents, and caregivers was evaluated by telephone survey of parents or caregivers and by retrospective chart review of the number of pre- and postoperative healthcare visits and antibiotic usage. Chart review showed a significant postoperative reduction in the number of clinic visits and in use of antibiotic drugs after insertion of tympanostomy tubes. Improved postoperative hearing was noted, and tympanostomy tube insertion was shown to be safe. The chart-review cost analysis showed that tympanostomy tube insertion is a cost-effective treatment for otitis media in children, and the telephone survey results showed that it improves quality of life for children and their parents or other caregivers.

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Sandra, Ho, e David J. Kay. "Tympanostomy Tube Selection: A Review of the Evidence". International Journal of Head and Neck Surgery 7, n. 1 (2016): 17–22. http://dx.doi.org/10.5005/jp-journals-10001-1259.

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ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

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Fekete-Szabó, Gabriella, Fekete Kiss e László Rovó. "Gyermekkori otitis media serosa miatt tubussal ellátott betegek hosszú távú nyomon követése". Orvosi Hetilap 156, n. 46 (novembre 2015): 1859–64. http://dx.doi.org/10.1556/650.2015.30291.

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Introduction: The authors report about the efficacy of inserted tympanostomy tube in children with serous otitis media. Aim: The aim of the authors was to assess the status of eardrum, the function of Eustachian tube and hearing level 10 years after the use of tympanostomy tube. Method: Patients filled up a questionnaire and microscopic examination of tympanic membrane, tympanometry, Eustachian tube function examination, and audiometry tests were performed. Results: In the period of 2003–2004, ventilation tube insertion was performed in 711 patients in the ENT Department of Pediatric Health Center of University of Szeged. In 349 patients adenotomy and tympanostomy tube insertion, in 18 cases tonsillectomy and grommet insertion and in 344 patients only typmanostomy tube insertion were performed. Due to objective difficulties (address change, no phone number) 453 patients were asked for control test and 312 persons accepted the invitation. Normal hearing level was found in 84.6% of patients and normal tympanometry result occurred in 82%. Tympanic ventilation disorder, perforation of tympanic membrane, sensorineural hearing loss and sensorineural hearing loss due to noise exposure were diagnosed. Conclusions: Application of tympanostomy tube is effective in the treatment of serous otitis media resulting from ventilation disorder. The authors draw attention to the importance of tympanometry examination to prevent the adhesive processes and cholesteatoma in chronic ventilation disorder of the middle ear. Orv. Hetil., 2015, 156(46), 1859–1864.

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Rahim, Ghassan Hassan. "Tympanostomy Tube Complication in Otitis Media with Effusion". AL-Kindy College Medical Journal 15, n. 2 (30 gennaio 2020): 58–61. http://dx.doi.org/10.47723/kcmj.v15i2.163.

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Background: Otitis media with effusion is characterized by accumulation of fluid in the middle ear in absence of acute inflammation and it is the most common cause of acquired hearing loss in children, and may negatively affect language development failure of medical treatment of middle ear effusion frequently require myringotomy and tympanostomy tube insertion. Objectives: To determine tympanostomy tube complications of tube in children with chronic otitis media with effusion who were treated with Shah Grommet tube insertion. Methods: The Medical records of 162 ears of 87 children (52 male and 35 female) were reviewed respectively, the patients ages were between 3 to 16 years old (mean age =8.11 years), patient were followed for 6-66 months (mean 23.3) after tympanostomy tube insertion. Tube extrusion time was also reviewed in all patients, and the indication for surgery was chronic middle ear effusion. Results: Otorrhea accured in nine ears (5.6%), granulation tissue was seen in 2 ears (1.2%), myringosclerosis in (34.6%) persistent perfor-ation (5.6%), atrophy (23.5%) retraction (16.7%) and medial displacement 1.2% the average extrusion time was 8.5 month ( ± 4.6). Conclusions: complications of tympanostomy tube insertion are common and the most common are otorrhea myringosclerosis, atrophy but they are generally insignificant consequently in majority of these complications there is no need for management.

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Allen, Jacqui, Randall P. Morton e Zahoor Ahmad. "Early post-operative morbidity after tympanostomy tube insertion". Journal of Laryngology & Otology 119, n. 9 (settembre 2005): 699–703. http://dx.doi.org/10.1258/0022215054798005.

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Insertion of ventilation tubes is regarded as a simple, effective and safe treatment for recurrent otitis media or prolonged middle-ear effusions. We conducted a prospective observational study of 112 children to ascertain what early post-operative complications were experienced. Our findings were consistent with previously published figures for post-surgical otorrhoea and obstruction rates, at 13.5 per cent and 4 per cent (by ear), respectively, using intra-operative administration of antibiotic/steroid ear drops. We identified unique characteristics of differing ethnic groups with regard to findings at surgery and post-operative outcomes. There was a tendency for grommets placed in the left ear to be extruded early and Maori andPacific Islanders were significantly more likely to have a non-functioning tube (blocked or extruded) in the early post-operative period. Overall, one in four children developed a post-operative complication (otorrhoea or non-functioning tube) suggesting that early and close follow up may allow timely identification and intervention where required.

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Egeli, Erol, e Muzaffer Kiriş. "Is Aspiration Necessary Before Tympanostomy Tube Insertion?" Laryngoscope 108, n. 3 (marzo 1998): 443–44. http://dx.doi.org/10.1097/00005537-199803000-00024.

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Liang, Wenyu, e Kok Kiong Tan. "Force Feedback Control Assisted Tympanostomy Tube Insertion". IEEE Transactions on Control Systems Technology 25, n. 3 (maggio 2017): 1007–18. http://dx.doi.org/10.1109/tcst.2016.2591323.

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Filip, Peter, Aparna Govindan e Maura Cosetti. "In-office myringotomy and tympanostomy tube insertion". Operative Techniques in Otolaryngology-Head and Neck Surgery 32, n. 2 (giugno 2021): 104–10. http://dx.doi.org/10.1016/j.otot.2021.05.007.

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Knutsson, J., e M. von Unge. "Five-year results for use of single-flanged tympanostomy tubes in children". Journal of Laryngology & Otology 122, n. 6 (1 agosto 2007): 584–89. http://dx.doi.org/10.1017/s0022215107009942.

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AbstractAims:To assess the five-year outcome of the use of single-flanged tympanostomy tubes in children, including the time to extrusion, rate of retained tubes and rate of persistent perforation.Materials and methods:The medical records relating to 640 single-flanged tympanostomy tubes intended for short-term use in paediatric patients were retrospectively reviewed.Results and analysis:We found that 36.4 per cent of the tubes had extruded within 12 months and 71.0 per cent within 24 months. Results showed that 14.1 per cent of the tubes had been removed because of prolonged retention, with a mean time to removal of 38.9 months. The time to extrusion was longer and the rate of retained tubes was higher than those reported for several other short-term tubes. We found that 4.5 per cent of tube insertions had resulted in a persistent perforation, a higher percentage than previously reported for other tubes intended for short-term use. Within five years of tube insertion, 70.5 per cent of the tympanic membranes had normalised.

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Wassef, David W., Nehal Dhaduk, Savannah C. Roy, Gregory L. Barinsky e Evelyne Kalyoussef. "Helping Children with Special Needs: Who Receives Tympanostomy Tubes?" Annals of Otology, Rhinology & Laryngology 130, n. 8 (16 gennaio 2021): 954–60. http://dx.doi.org/10.1177/0003489420987425.

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Objectives: Tympanostomy tubes can prevent sequelae of otitis media that adversely affect long term hearing and language development in children. These negative outcomes compound the existing difficulties faced by children who are already diagnosed with developmental disorders. This study aims to characterize this subset of children with developmental disorders undergoing myringotomy and tympanostomy tube insertion. Methods: A retrospective review using the Kids’ Inpatient Database (KID) was conducted, with codes from International Classification of Diseases, Ninth Revision used to query data from the years 2003 to 2012 to determine a study group of children with a diagnosis of a developmental disorder undergoing myringotomy and tympanostomy insertion. This group was compared statistically to patients undergoing these procedures who did not have a diagnosed developmental disorder. Results: In total, 21 945 cases of patients with myringotomy with or without tympanostomy tube insertion were identified, of which 1200 (5.5%) had a diagnosis of a developmental disorder. Children with developmental disorders had a higher mean age (3.3 years vs 2.9 years, P = .002) and higher mean hospital charges ($43 704.77 vs $32 764.22, P = .003). This cohort also had higher proportions of black (17.6% vs 12.3%, P < .001) and Hispanic (23.9% vs 20.6%, P = .014) patients, and had lower rates of private insurance coverage (39.6% vs 49%, P < .001). Conclusion: The population of children with developmental disorders undergoing myringotomy or tympanostomy tube placement has a different demographic composition than the general population and faces distinct financial and insurance coverage burdens. Further study should be done to assess if these differences impact long term outcomes.

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Brigger, Matthew, e Justin Wilson. "Evidence-Based Guidelines: Tympanostomy Tube Insertion and Adenotonsillectomy". Journal of Pediatric Infectious Diseases 14, n. 02 (6 luglio 2018): 029–36. http://dx.doi.org/10.1055/s-0038-1660870.

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AbstractMyringotomy with tympanostomy tube placement and tonsillectomy (with or without adenoidectomy) are two of the most common procedures performed in the pediatric population. Indications for these surgical treatments are for correspondingly prevalent conditions affecting children, including middle ear and adenotonsillar disease, which are treated by many specialty groups spanning family physicians, pediatricians, emergency care physicians, and otolaryngologists. Despite the common nature of these diseases and respective indicated surgeries, their management has in the past had limited evidence-based guidelines. This article consolidates the most up-to-date evidence from the otolaryngology, pediatric, and infectious disease literature to guide the management with tympanostomy tube insertion and adenotonsillectomy in the pediatric population.

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Vlastos, I. M., M. Houlakis, D. Kandiloros, L. Manolopoulos, E. Ferekidis e I. Yiotakis. "Adenoidectomy plus tympanostomy tube insertion versus adenoidectomy plus myringotomy in children with obstructive sleep apnoea syndrome". Journal of Laryngology & Otology 125, n. 3 (16 dicembre 2010): 274–78. http://dx.doi.org/10.1017/s0022215110002549.

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AbstractObjective:To determine whether tympanostomy tube insertion has benefit, compared with simple myringotomy, in children with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome caused by adenoid hypertrophy.Methods:Fifty-two children older than three years with obstructive sleep apnoea syndrome were randomly assigned to receive either adenoidectomy plus tympanostomy tube insertion (group one, n = 25) or adenoidectomy plus myringotomy (group two, n = 27). Pre- and post-operative health-related quality of life was assessed using the otitis media-6 (OM-6) tool, and audiological outcomes were recorded six and 12 months post-operatively.Results:Group one showed better quality of life scores six months post-operatively (score difference −0.38, confidence interval −0.65 to −0.10) but not 12 months post-operatively (score difference −0.23, confidence interval −0.76 to 0.11), compared with pre-operative values. Audiological outcomes did not differ significantly at either time point, compared with pre-operative values.Conclusion:Tympanostomy tube insertion confers a short term benefit, compared with simple myringotomy, in children older than three years with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome. Further studies are necessary to identify which of these children will receive long-lasting benefit from tympanostomy tube insertion.

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26

Rosenfeld, Richard M. "Tympanostomy Tube Controversies and Issues: State-of-the-Art Review". Ear, Nose & Throat Journal 99, n. 1_suppl (13 aprile 2020): 15S—21S. http://dx.doi.org/10.1177/0145561320919656.

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Objective: To review current pragmatic issues and controversies related to tympanostomy tubes in children, in the context of current best research evidence plus expert opinion to provide nuance, address uncertainties, and fill evidence gaps. Methods: Each issue or controversy is followed by the relevant current best evidence, expert insight and opinion, and recommendations for action. The role of expert opinion and experience in forming conclusions is inversely related to the quality, consistency, and adequacy of published evidence. Conclusions are combined with opportunities for shared decision-making with caregivers to recommend pragmatic actions for clinicians in everyday settings. Results: The issues and controversies discussed include (1) appropriate tube indications, (2) rationale for not recommending tubes for recurrent acute otitis media without persistent middle ear effusion, (3) role of tubes in at-risk children with otitis media with effusion, (4) role of new, automated tube insertion devices, (5) appropriateness and feasibility of in-office tube insertion in awake children, (6) managing methicillin-resistant Staphylococcus aureus acute tube otorrhea, and (7) managing recurrent or persistent tube otorrhea. Conclusions: Despite a substantial, and constantly growing, volume of high-level evidence on managing children with tympanostomy tubes, there will always be gaps, uncertainties, and controversies that benefit from clinician experience and expert opinion. In that regard, the issues discussed in this review article will hopefully aid clinicians in everyday, pragmatic management decisions.

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Ragab, Ahmed, AhmedAbdel-Haleem Mohammed, AymanAli Abdel-Fattah e AhmedMohammed Afifi. "Prevalence of complications associated with tympanostomy tube insertion". Menoufia Medical Journal 28, n. 4 (2015): 918. http://dx.doi.org/10.4103/1110-2098.173673.

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28

Paparella, M. M. "Early Post-operative Morbidity After Tympanostomy Tube Insertion". Yearbook of Otolaryngology-Head and Neck Surgery 2006 (gennaio 2006): 71–72. http://dx.doi.org/10.1016/s1041-892x(08)70070-2.

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29

Giebink, G. S., K. Daly, D. J. Buran, M. Satz e T. Ayre. "Predictors for Postoperative Otorrhea Following Tympanostomy Tube Insertion". Archives of Otolaryngology - Head and Neck Surgery 118, n. 5 (1 maggio 1992): 491–94. http://dx.doi.org/10.1001/archotol.1992.01880050037009.

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30

Anari, S. "A simple technique for tympanostomy T-tube insertion". Clinical Otolaryngology 33, n. 3 (giugno 2008): 296–97. http://dx.doi.org/10.1111/j.1749-4486.2008.01706.x.

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31

DAYA, H., A. E. HINTON, P. RADOMSKIEJ e P. HUCHZERMEYER. "Otoacoustic emissions: assessment of hearing after tympanostomy tube insertion". Clinical Otolaryngology 21, n. 6 (dicembre 1996): 492–94. http://dx.doi.org/10.1111/j.1365-2273.1996.tb01097.x.

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32

Ramadan, H. H., T. Tarazi e G. M. Zaytoun. "Use of Prophylactic Otic Drops After Tympanostomy Tube Insertion". Archives of Otolaryngology - Head and Neck Surgery 117, n. 5 (1 maggio 1991): 537. http://dx.doi.org/10.1001/archotol.1991.01870170083018.

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33

Parker, Gregg S., Thomas A. Tami, Michael R. Maddox e Joseph F. Wilson. "The effect of water exposure after tympanostomy tube insertion". American Journal of Otolaryngology 15, n. 3 (maggio 1994): 193–96. http://dx.doi.org/10.1016/0196-0709(94)90004-3.

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34

Orobello, Peter W., Robert I. Park, Randall C. Wetzel, Laura J. Belcher e Robert M. Naclerio. "Phenol as an adjuvant anesthetic for tympanostomy tube insertion". International Journal of Pediatric Otorhinolaryngology 21, n. 1 (febbraio 1991): 51–58. http://dx.doi.org/10.1016/0165-5876(91)90059-k.

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35

Gleinser, David M., Hilda H. Kriel e Shraddha Mukerji. "The relationship between repeat tympanostomy tube insertion and adenoidectomy". International Journal of Pediatric Otorhinolaryngology 75, n. 10 (ottobre 2011): 1247–51. http://dx.doi.org/10.1016/j.ijporl.2011.06.023.

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36

Shanks, Janet E., Patricia G. Stelmachowicz, Kathryn L. Beauchaine e Laura Schulte. "Equivalent Ear Canal Volumes in Children Pre- and Post-Tympanostomy Tube Insertion". Journal of Speech, Language, and Hearing Research 35, n. 4 (agosto 1992): 936–41. http://dx.doi.org/10.1044/jshr.3504.936.

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Pre- and postoperative equivalent ear canal volume measures were obtained from a group of 334 children ranging in age from 6 weeks to 6.7 years. The purpose of the study was to develop volumetric guidelines for the determination of tympanostomy tube patency. For children 4 years and older, almost no ambiguity existed in making this determination accurately. For younger children, the pre- and postoperative distributions overlap. A criterion value of ≥1.0 cm 3 as an indicator of a tympanic membrane perforation appears to yield the lowest possible error rate. When both pre- and postoperative measures are available, a difference of ≥0.4 cm 3 can be used in conjunction with the absolute value to identify a patent tympanostomy tube.

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37

Basu, S., C. Georgalas, P. Sen e A. K. Bhattacharyya. "Water precautions and ear surgery: evidence and practice in the UK". Journal of Laryngology & Otology 121, n. 1 (14 novembre 2006): 9–14. http://dx.doi.org/10.1017/s0022215106003136.

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Background: Patients are traditionally advised to refrain from exposing their ears to water after most otological procedures. However, recent evidence suggests that water does not adversely affect the outcome for children with tympanostomy tubes. The evidence behind the potential harmful effects of water on the outcome of other otological procedures is scarce.Objective: The study was done to determine the current practice of otolaryngology consultants in the UK on the advice given to patients regarding swimming, diving and bathing in soapy water after myringotomy and tympanostomy tube insertion, mastoidectomy and myringoplasty.Method: Questionnaire based survey mailed to 382 members (consultants only) of the British Association of Otolaryngologists – Head & Neck Surgeons in the UK.Results: A total of 195 responses were received (reply rate 51 per cent). In all, 95.6 per cent of the respondents allowed their patients to swim after insertion of tympanostomy tubes, with 32.9 per cent insisting on the use of earplugs until extrusion of the tympanostomy tubes. However, 61.6 per cent of the respondents restricted diving in these patients. In comparison, the respondents were more conservative with water precautions following myringoplasty and mastoidectomy. More than half the respondents recommended earplugs for bathing after all three operations.Conclusion: This study reveals current national practice among UK otolaryngologists. There is no general consensus in post-operative advice following otolaryngological procedures, indicating a need for national guidelines.

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38

Yaman, Huseyin, Ender Guclu, Suleyman Yilmaz e Ozcan Ozturk. "Myringosclerosis after tympanostomy tube insertion: Relation with tube retention time and gender". Auris Nasus Larynx 37, n. 6 (dicembre 2010): 676–79. http://dx.doi.org/10.1016/j.anl.2010.02.007.

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39

Secor, Chad P., Robert E. Wilson, Paul M. Spring e Richard C. Haydon. "Gelatin sponge insertion into tympanostomy tubes: An in-vitro study to evaluate postoperative obstruction". Otolaryngology–Head and Neck Surgery 140, n. 5 (maggio 2009): 661–64. http://dx.doi.org/10.1016/j.otohns.2009.01.016.

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Objective: To analyze the efficacy of gelatin sponge insertion into lumens of tympanostomy tubes to prevent obstruction in the presence of blood. Study Design: In vitro model. Methods: Absorbable gelatin sponge wicks were placed in the lumen of Ultrasil Collar Button ventilation tubes and Shepherd Grommet ventilation tubes. One half of each group was covered with blood, the other left untreated. Each tube was treated with ofloxacin solution three times daily for seven days. After treatment, the tubes were inspected. Reinspection was performed after brief suctioning. Numerical scores were given based on degree of obstruction. Results: A statistically significant difference in degree of obstruction ( P < 0.0001) was seen between all tubes with wicks alone versus those with blood added. After re-evaluation, there remained a statistically significant difference between tubes with wicks alone and tubes with wicks and blood ( P < 0.0001). Conclusions: Gelatin sponge insertion does not prevent, and may in fact, enhance, obstruction of pressure equalization tube lumens in the presence of blood.

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40

Jassar, P., A. Sibtain, D. Marco, J. Jose e G. Hunter. "Infection rates after tympanostomy tube insertion, comparing Aboriginal and non-Aboriginal children in the Northern Territory, Australia: a retrospective, comparative study". Journal of Laryngology & Otology 123, n. 5 (25 giugno 2008): 497–501. http://dx.doi.org/10.1017/s002221510800306x.

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AbstractObjective:To determine if there is a difference in infection rates between Aboriginal and non-Aboriginal children, following tympanostomy and ventilation tube placement, in the Northern Territory, Australia.Materials and methods:A cohort of 213 patients aged zero to 10 years who had undergone tympanostomy and ventilation tube placement at the Royal Darwin Hospital between 1996 and 2004 were identified. Patients were divided into Aboriginal or non-Aboriginal groups, from their medical record. Factors such as age, sex, dwelling (remote or urban) and season were compared for each group, in order to ascertain if they contributed to infection rates. A retrospective analysis of cases was conducted for the two-year post-operative period.Results:There was no statistically significant difference in infection rates between the two groups (37 vs 35 per cent). There was no statistically significant difference when comparing the two groups for age, sex, season, or remote vs urban dwelling.Conclusion:Aboriginal children were not prone to more infections following tympanostomy tube placement when compared with non-Aboriginal children.

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41

Marom, Tal, Nadeem Habashi, Robert Cohen e Sharon Ovnat Tamir. "Role of Biofilms in Post-Tympanostomy Tube Otorrhea". Ear, Nose & Throat Journal 99, n. 1_suppl (24 marzo 2020): 22S—29S. http://dx.doi.org/10.1177/0145561320914437.

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Objective: Nearly half of children who undergo tympanostomy tube (TT) insertion may experience otorrhea following surgery. We sought to review the evidence for the role of bacterial biofilms in post-tympanostomy tube otorrhea (PTTO) and the accumulated experience regarding the preventive measures for biofilm formation/adhesion on TTs. Methods: English literature search for relevant MeSH keywords was conducted in the following databases: MEDLINE (via PubMed), Ovid Medline, Google Scholar, and Clinical Evidence (BMJ Publishing) between January 1, 1995, and December 31, 2019. Subsequently, articles were reviewed and included if biofilm was evident in PTTO. Results: There is an increased evidence supporting the role of biofilms in PTTO. Studies on TT design and material suggest that nitinol and/or silicone TTs had a lower risk for PTTO and that biofilms appeared in specific areas, such as the perpendicular junction of the T-tubes and the round rims of the Paparella-type tubes. Biofilm-component DNAB-II protein family was present in half of children with PTTO, and targeting this protein may lead to biofilm collapse and serve as a potential strategy for PTTO treatment. Novel approaches for the prevention of biofilm-associated PTTO include changing the inherent tube composition; tube coating with antibiotics, polymers, plant extracts, or other biofilm-resistant materials; impregnation with antimicrobial compounds; and surface alterations by ion-bombardment or surface ionization, which are still under laboratory investigation. Conclusions: Currently, there is no type of TT on which bacteria will not adhere. The challenges of treating PTTO indicate the need for further research in optimization of TT design, composition, and coating.

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42

Garcia, Philip, George A. Gates e Kenneth B. Schechtman. "Does Topical Antibiotic Prophylaxis Reduce Post—Tympanostomy Tube Otorrhea?" Annals of Otology, Rhinology & Laryngology 103, n. 1 (gennaio 1994): 54–58. http://dx.doi.org/10.1177/000348949410300110.

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Purulent otorrhea is the most common complication of tympanostomy tube (TT) insertion. It may occur in the postoperative period or at any time during the sojourn of the tube. The efficacy of topical antimicrobial prophylaxis against purulent postoperative otorrhea (PPO) has been examined in 5 prospective, randomized studies; all demonstrated a reduction in PPO from topical antimicrobial prophylaxis, but in only 1 study was the difference statistically significant. Because the 5 studies used 2 different experimental designs — By-patient, and by-ear — a single meta-analysis could not be done. However, the by-patient studies met the criteria for meta-analysis, which demonstrated a combined odds ratio of 0.12 (95% confidence interval 0.04 to 0.37, p = .0002). This represents an 85% reduction in otorrhea, which is judged to be clinically as well as statistically significant. We conclude from the available evidence that prophylactic use of topical antimicrobial agents following TT insertion consistently reduces the rate of PPO. However, the low incidence of PPO and the heterogeneity of the published studies prevent making a final judgment for or against the continued use of these agents. Therefore, given that these potentially ototoxic agents are frequently administered to prevent postoperative otorrhea, further study of this subject is warranted. In the meantime, we recommend judicious use of these agents following TT insertion in those cases at higher risk for PPO, namely those with mucoid or purulent effusion.

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43

Scott, Bruce A., e Chester L. Strunk. "Post-Tympanostomy Otorrhea: A Randomized Clinical Trial of Topical Prophylaxis". Otolaryngology–Head and Neck Surgery 106, n. 1 (gennaio 1992): 34–41. http://dx.doi.org/10.1177/019459989210600125.

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Myringotomy with the insertion of tympanostomy tubes has become the most frequently performed otolaryngologic procedure, and otorrhea is the most common post-tympanostomy complication. Many otolaryngologists routinely use prophylactic topical antibiotic solutions when performing tympanostomy tube placement. Relatively little has been written regarding early post-tympanostomy otorrhea and scarcely any examining the efficacy of such prophylaxis. The current study is a randomized clinical trial to critically evaluate the efficacy of prophylactic otic drops after tympanostomy tube placement. The ototoxic potential of these solutions, combined with constant pressures to decrease medication expenses and eliminate unnecessary use of antibiotics, makes determination of the shortest effective course of application paramount. Subjects were randomized at the time of surgery into one of three groups; one group received no prophylaxis, a second group received gentamicin otic drops Immediately after tympanostomy tube placement in the operating room only, and the third group received an additional 48 hours of drops (4 drops in each ear, three times a day). All patients were seen within 2 weeks postoperatively. An overall early post-tympanostomy otorrhea incidence of 8.7% is documented with 12%, 8.8%, and 5.6% for each study group, respectively. While these findings may suggest possible efficacy of topical prophylaxis, a statistically significant difference between the treatment groups was not proved ( p = 0.62). Further analysis by subdivision of the patients, on the basis of middle ear cavity finding at the time of surgery, reveals a highly significant statistical association of the occurrence of post-tympanostomy otorrhea in ears having mucoid effusions ( p < 0.001) as compared to ears without effusion or with serous effusions. On the basis of the results of this randomized trial, the routine prophylactic use of potentially ototoxic topical solutions does not appear to be Justified in patients found to have a middle ear cleft that is dry or has a serous effusion. Patients found to have mucoid effusions are at statistically significantly higher risk of development of otorrhea postoperatively. Use of prophylactic otic drops may be indicated in this group.

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Paradise, Jack L. "Generalizability of randomized trial results: Tympanostomy-tube insertion and tonsillectomy". Otolaryngology–Head and Neck Surgery 140, n. 3 (marzo 2009): 439–40. http://dx.doi.org/10.1016/j.otohns.2008.12.018.

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45

Villanueva, Jose Carlo R., e Alejandro P. Opulencia. "Myringotomy and Tympanostomy Tube Insertion Training Device: A Surgical Simulator". Otolaryngology–Head and Neck Surgery 151, n. 1_suppl (settembre 2014): P218. http://dx.doi.org/10.1177/0194599814541629a256.

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46

Hu, Shirley, Neha A. Patel e Shai Shinhar. "Follow-up audiometry after bilateral myringotomy and tympanostomy tube insertion". International Journal of Pediatric Otorhinolaryngology 79, n. 12 (dicembre 2015): 2068–71. http://dx.doi.org/10.1016/j.ijporl.2015.09.015.

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47

Shinkwin, C. A., G. E. Murty, R. Simo e N. S. Jones. "Per-operative antibiotic/steroid prophylaxis of tympanostomy tube otorrhoea: chemical or mechanical effect?" Journal of Laryngology & Otology 110, n. 6 (giugno 1996): 531–33. http://dx.doi.org/10.1017/s0022215100134188.

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AbstractThe per-operative instillation of ototopical antibiotic/steroid drops reduces the incidence of early otorrhoea after tympanostomy tube insertion. Whether this is due to the chemical properties of the antibiotic/steroid or simply the mechanical instillation of fluid is unclear. In this paired matched study of 161 subjects Gentisone HC was shown to significantly reduce the otorrhoea rate compared to normal saline (1.24 per cent compared with 9.32 per cent, p<0.005, difference 8.07 per cent, 95 per cent confidence interval for difference 3.21 per cent to 12.93 per cent). Capillary viscosimetry proved Gentisone HC to be more viscous than normal saline. The benefits are due to Gentisone HC's chemical properties, and Gentisone HC rather than normal saline instillation per-operatively is recommended when tympanostomy tubes are inserted.

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48

LEE, C., e K. RO. "Rate of General Anesthesia After Laser Tympanostomy and Ventilation Tube Insertion". Otolaryngology - Head and Neck Surgery 133, n. 2 (agosto 2005): P246. http://dx.doi.org/10.1016/j.otohns.2005.05.600.

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49

Clary, Randall A., Robert S. Bahadori, Harlan R. Muntz e Rodney P. Lusk. "Bacteria in the middle ear and nasopharynx during tympanostomy tube insertion". American Journal of Otolaryngology 19, n. 5 (settembre 1998): 301–4. http://dx.doi.org/10.1016/s0196-0709(98)90002-3.

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SUZUKI, Hideaki, Shigeru NAKATSUKA, Toshihiko CHIBA e Tomonori TAKASAKA. "Tympanostomy Tube Insertion for Children under General Anesthesia in Day Surgery." Practica Oto-Rhino-Laryngologica 88, n. 9 (1995): 1135–39. http://dx.doi.org/10.5631/jibirin.88.1135.

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