Cemented Titanium Ventilation Tube in the Chinchilla

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P99-P99
Author(s):  
Jeffery J Kuhn ◽  
Scott R Anderson ◽  
Barry Strasnick
Keyword(s):  
Bone Cement ◽  
Middle Ear ◽  
Medial Wall ◽  
Ventilation Tube ◽  
Novel Technique ◽  
Middle Ear Ventilation ◽  
Ventilation Tubes ◽  
Titanium Tube ◽  
Long Term Ventilation

Problem The use of long-term ventilation tubes in patients with chronic eustachian tube dysfunction is an acceptable form of initial surgical treatment. Despite improvements in composition and design, early extrusion, occlusion, and need for repeated procedures continue to be frequent problems encountered in the course of treatment. The purpose of this study was to develop a novel technique for establishing permanent middle ear ventilation. The study was conducted following the refinement of surgical techniques and long-term follow-up in a pilot group of animals. Methods Heat cautery myringotomy was used to expose the middle ear space in both ears of 15 chinchillas. A titanium ventilation tube was fixed to the medial wall of the hypotympanum in each ear using OtoMimix hydroxyapatite bone cement. At four months, both ears in 12 animals were re-explored and the integrity of the cemented tube was assessed clinically. One animal was euthanized and the temporal bones obtained for histopathologic analysis. Results A stable fixation of the titanium tube to the medial wall of the hypotympanum was demonstrated in 23 of 24 ears at four months re-exploration. The titanium tube-bone cement fixture was covered with healthy vascularized mucosa in all ears. Two ears showed mild mucosal inflammation adjacent to the fixed tube. The histologic findings will be reviewed. Conclusion The use of hydroxyapatite bone cement to permanently secure a titanium tube to the middle ear wall appears to have some promise as a technique for establishing long-term ventilation of the middle ear space. A prototype titanium tube is currently being developed for this purpose. Significance By incorporating the proven technologies of titanium implants and hydroxyapatite bone cement, this study provides a novel technique for establishing a permanent means of middle ear ventilation. Support The ventilation tubes (Gyrus ENT LLC) and bone cement (Walter Lorenz Surgical, Inc.) were supplied by their respective manufacturers.

Long-term ventilation of the middle ear using a tympanotomy technique

1995 ◽  
Vol 109 (12) ◽  
pp. 1151-1154 ◽  
Author(s):  
D. P. Martin-Hirsch ◽  
C. J. Woodhead ◽  
C. E. Vize
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Middle Ear Effusion ◽  
Tympanostomy Tubes ◽  
Middle Ear Ventilation ◽  
Ventilation Tubes ◽  
Long Term Ventilation ◽  
Ear Effusion

AbstractThe technique of long-term middle ear ventilation using a tympanotomy technique is presented. This has proved successful in the management of persistent middle ear effusion despite numerous previous short- and intermediate-term tympanic membrane ventilation tubes. The technique is particularly appropriate in the presence of severe tympanoscierosis as a result of previous tympanostomy tubes, posterior tympanic membrane collapse and adhesion, and atelectasis.

A New Ventilation Tube for Long-Term Middle Ear Ventilation

2002 ◽  
Vol 112 (11) ◽  
pp. 2054-2056 ◽  
Author(s):  
P. Bonvin ◽  
B. Bakke Hansen ◽  
E. Hentzer
Keyword(s):  
Middle Ear ◽  
Ventilation Tube ◽  
Middle Ear Ventilation

Complications of long-term ventilation tubes

2013 ◽  
Vol 127 (5) ◽  
pp. 509-510 ◽  
Author(s):  
H Mohammed ◽  
P Martinez-Devesa
Keyword(s):  
Ventilation Tube ◽  
Material Degradation ◽  
Long Term Follow Up ◽  
Ventilation Tubes ◽  
Chronic Inflammatory Reaction ◽  
Materials Used ◽  
Long Term Ventilation

AbstractObjective:To demonstrate that ventilation tubes can remain in situ much longer than expected, and that the materials used in the manufacturing of these tubes can degrade and cause complications. Long-term follow up and replacement of the tube is recommended.Method:Case report and review of the literature concerning the use of long-term ventilation tubes.Results:In the case reported, the ventilation tube was in place for 19 years, which resulted in chronic ear discharge. When it was removed, it was noted that the tube itself had degraded and had caused a chronic inflammatory reaction.Conclusion:We recommend that the long-term use of ventilation tubes is followed up and that the tube is replaced before material degradation takes place.

Prolonged Middle Ear Ventilation: The Right Tube in the Right Place

1983 ◽  
Vol 92 (6) ◽  
pp. 582-586 ◽  
Author(s):  
B. W. Armstrong
Keyword(s):  
Middle Ear ◽  
Suction Device ◽  
Small Incision ◽  
Middle Ear Ventilation ◽  
Ventilating Tubes ◽  
Tube Migration ◽  
Insertion Tool ◽  
Long Term Ventilation ◽  
The Right

Premature extrusion of ventilating tubes continues to plague both doctor and patient. Migrating epithelium on the lateral surface of the drum has been identified as the principal cause of tube migration and extrusion. This information dictates insertion of a tube in an area where the migrating forces tend to keep the tube in place instead of encouraging rejection. When optimally placed, tubes specifically designed for long-term ventilation will function four times longer than randomly placed conventional tubes. The long-term ventilating tube in use since 1965 has been further refined. A notch and tab on the tube mate with a new inserter/suction device, and this combination permits precise placement through a small incision without tilting and twisting during insertion. Suction may be applied as desired to clear the lumen as the insertion tool is withdrawn.

scholarly journals Long-term Middle Ear Ventilation Tube (Paparella type II) for Otitis Media with Effusion.

2001 ◽  
Vol 94 (2) ◽  
pp. 113-117
Author(s):  
Ryuichi Kobayashi ◽  
Hiroshi Furuta ◽  
Hiroshi Hoshikawa ◽  
Rieko Goto ◽  
Masayuki Karaki ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Type Ii ◽  
Ventilation Tube ◽  
Middle Ear Ventilation

scholarly journals The Middle Ear in Cleft Palate Children Pre and Post Palatal Closure

1988 ◽  
Vol 81 (12) ◽  
pp. 710-713 ◽  
Author(s):  
R S Dhillon
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Prospective Trial ◽  
Ventilation Tube ◽  
Long Term Ventilation ◽  
Palatal Surgery

A multicentre prospective trial was commenced in July 1984 to establish the incidence of otitis media with effusion (OME) in children born with a cleft of the palate. Additionally, the data recorded would allow an assessment of the effect of palatal closure on middle ear function. Prior to palatal closure, 97% of ears in a group of 50 patients had otitis media with effusion (OME). The insertion of a long-term ventilation tube provided a means of aeration of one ear with the non-ventilated ear acting as a control. Eighty percent of control ears had persistent OME during a 24-month follow-up period post palatal repair. It would seem that OME is universally present in children with a cleft palate prior to 4 months of age and this incidence is only marginally diminished by palatal surgery. The liaison between plastic surgical and ENT units should be even closer than before in order to manage these patients satisfactorily.

scholarly journals Clinical Factors Associated With the Outcomes of Long-Term Middle Ear Ventilation Tube Insertion in Pediatric Patients

2021 ◽  
pp. 014556132110264
Author(s):  
Shunsuke Takai ◽  
Kazuhiro Nomura ◽  
Kiyoshi Oda ◽  
Daiki Ozawa ◽  
Mihoko Irimada ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Ventilation Tube ◽  
Rate Of Increase ◽  
Effective Option ◽  
Middle Ear Ventilation ◽  
History Of

Background: Ventilation tube (VT) insertion is the most common treatment for otitis media with effusion (OME). However, OME recurrence and persistent tympanic membrane (TM) perforation after VT removal are encountered in a certain percentage of such children. Methods: This study was performed to determine the outcomes of children who underwent long-term VT insertion. A total of 326 ears from 192 patients were analyzed. The associations among the patient age, sex, history of OME, history of repeated acute otitis media, placement duration, whether the VT had been removed intentionally or spontaneously, and the outcome (persistent TM perforation or OME recurrence) were analyzed. The outcomes of multiple VT tube insertions were also reviewed. We also analyzed whether or not local or general anesthesia was associated with the early spontaneous extrusion of the VT. Result: The OME recurrence and TM perforation rates were 29% (96/326 sides) and 17% (57/326 sides), respectively, for first insertions. In addition, 96 (29%) sides underwent ≥2 insertions. The shorter the duration for which the VT was retained in the middle ear, the more significant the rate of increase in OME recurrence. The OME recurrence was observed more often when VT was spontaneously removed than when intentionally removed. The rate of persistent TM perforation was significantly associated with male sex. Persistent TM perforation was not observed in patients who underwent 4 or 5 insertions. The anesthesia method did not significantly influence the timing of spontaneous extrusion of VT. Conclusion: The retention period of VT should be at least 2 years, and VT removal at the age of 7 might be a viable strategy. Multiple VT insertions are recommended for patients with recurrent OME. Ventilation tube under local anesthesia is an effective option for tolerable children.

Long-term ventilation of the middle ear using a subannular tympanotomy technique: a follow-up study

2004 ◽  
Vol 118 (12) ◽  
pp. 933-936 ◽  
Author(s):  
P. Jassar ◽  
A. Coatesworth ◽  
D.R. Strachan
Keyword(s):  
Middle Ear ◽  
Perforation Rate ◽  
Original Series ◽  
T Tube ◽  
Follow Up Study ◽  
Middle Ear Ventilation ◽  
Long Term Ventilation ◽  
Ear Effusion

The results of a nine-year series of patients who underwent long-term middle ear ventilation using a tympanotomy technique are presented. The original series of 26 cases was published in 1995. The same series has now expanded to 37 cases, which form the basis of this follow-up study. In contrast to the original series we found a high spontaneous extrusion rate (68 per cent) and in 27 per cent of cases complications necessitated removal of the subannular T tube. In favour of the technique was a low perforation rate after extrusion or removal (eight per cent). Although only nine per cent underwent re-ventilation this is unlikely to represent resolution of the middle ear effusion in the remaining cases.We conclude that the adverse effects of the subannular tympanotomy technique for long-term ventilation of the middle ear outweigh the benefits when compared with the traditional technique of placing a T tube through a myringotomy incision.

Long-term tympanic ventilation by Per-Lee tube

1986 ◽  
Vol 100 (5) ◽  
pp. 503-508 ◽  
Author(s):  
Alan G. Gibb
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Considerable Degree ◽  
Hearing Improvement ◽  
Secretory Otitis Media ◽  
Spontaneous Healing ◽  
Middle Ear Ventilation ◽  
Ventilation Tubes

AbstractThe fate of 32 Per-Lee ventilation tubes inserted by a single surgeon for secretory otitis media in children and adults is analysed over a 15-year period. There were no extrusions and 25 tubes were still functional at the time of the survey. The total ventilation time achieved by the 32 tubes was over 157 years. Seven tubes were removed on account of either obstruction or infection. Spontaneous healing of the tympanic membrane was uncertain following removal of the tube and a considerable degree of scarring was inevitable. Hearing improvement occurred while the tube was functioning and there were no cases of hearing deterioration. It is concluded that the Per-Lee tube is a suitable prosthesis for long-term middle-ear ventilation.

An unusual complication of T-tubes

1997 ◽  
Vol 111 (3) ◽  
pp. 282-283 ◽  
Author(s):  
K. M. J. Green ◽  
J. P. de Carpentier ◽  
J. W. A. Curley
Keyword(s):  
Middle Ear ◽  
Unusual Complication ◽  
The Third ◽  
T Tube ◽  
Ventilation Tubes ◽  
Long Term Ventilation ◽  
Middle Ear Cleft

AbstractThe morbidity of long-term ventilation tubes (Goode T-tubes) is often discussed with reference to otorrhoea, tympanosclerosis and long-term perforation. We report three cases of the T-tube slipping into the middle-ear cleft. In two of the three patients this was asymptomatic and the T-tubes were left in situ. In the third patient this complication was documented on three occasions when the T-tube was removed and reinserted for recurrent effusions. We are unaware of this complication being previously reported in the literature.

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