Closure of tympanic membrane perforation after the removal of Goode-type tympanostomy tubes: the use of silastic sheeting

AbstractThe reported incidence of persistent tympanic membrane perforation after the extrusion or removal of Goodetype tympanostomy tubes varies from 3 per cent to 47.5 per cent.A prospective randomized study of 152 Goode-type T-tube removals is presented. In one group of 79 ears, the edge of the defect was just freshened, but in the other 73 ears, the edge was freshened and a small piece of 0.13 mm silastic sheeting placed over the defect. Follow-up was performed at six weeks and three, six and nine months and shows that the use of silastic sheeting increases the rate of closure of the perforation and also significantly decreases the number of persistent perforations at nine months.

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Care of the Child With Tympanostomy Tubes: A Visual Guide for the Pediatrician

PEDIATRICS ◽

10.1542/peds.93.6.924 ◽

1994 ◽

Vol 93 (6) ◽

pp. 924-929

Author(s):

Glenn Isaacson ◽

Richard M. Rosenfeld

Keyword(s):

Tympanic Membrane ◽

Personal Communication ◽

The United States ◽

Tympanic Membrane Perforation ◽

Nonsurgical Management ◽

Tympanostomy Tubes ◽

Membrane Perforation ◽

Middle Ear Disease ◽

Available Information

More than 2 million tympanostomy tubes are placed annually in the United States, primarily in children with chronic or recurrent otitis media refractory to nonsurgical management (J.S. Reilly, personal communication, 1994). Traditionally, the operating otolaryngologist has had the responsibility of caring for these patients, including: confirming middle ear disease, assuring tube patency, controlling refractory otorrhea, and managing complications such as tympanic membrane perforation or cholesteatoma. In response to pressures from a changing health care system, pediatricians are less able to refer children back to the otolaryngologist for routine tube surveillance, and must therefore perform it themselves, often with incomplete instrumentation and training. An approach is presented here for the care of the child with tympanostomy tubes based on the authors' combined experience with thousands of intubated children, and on available information from the pediatric and otolaryngic literature. With appropriate postoperative surveillance and follow-up care, the morbidity from tympanostomy tubes can be minimized. Although there are other ways of achieving the same goals, these time-honored methods are safe and effective. Because this is a visual guide, photographs are liberally interspersed to clarify and reinforce the written material. NORMAL TUBE APPEARANCE There are hundreds of different tube designs and materials and at least five different potential insertion sites in the tympanic membrane. This bewildering array of devices can be reduced to two general types: short-term tubes (intended to remain in the eardrum for 8 to 15 months) and long-term tubes (intended to remain in the eardrum > 15 months) (Fig 1A and B).

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A rare cause of acute tympanic membrane perforation: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20185325 ◽

2018 ◽

Vol 5 (1) ◽

pp. 181

Author(s):

C. J. Timna ◽

Abhijit Kumar

Keyword(s):

Case Report ◽

Tympanic Membrane ◽

Sudden Onset ◽

Tympanic Membrane Perforation ◽

Complete Healing ◽

Accident And Emergency ◽

Membrane Perforation ◽

Accident And Emergency Department ◽

Perforated Tympanic Membrane

This is a case report of 57yrs old gentleman who presented to accident and emergency department with complaints of sudden onset of left earache, tinnitus, feeling of fullness in the ear which he claimed to start following an episode of sudden sneezing, while he was trying to blow his nose by pinching it with 2 fingers. The tympanic membrane was ruptured. He was managed conservatively with analgesics. Spontaneous and complete healing of the perforated tympanic membrane occured within one month of follow up. It was shown that an episode of sneezing with nose closed can build up such a high pressure in the middle ear which can perforate a tympanic membrane.

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A clinical study of traumatic tympanic membrane perforation

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213903 ◽

2021 ◽

Vol 7 (10) ◽

pp. 1668

Author(s):

Fida Harish A. T. ◽

Raghavendra Prasad K. U.

Keyword(s):

Tympanic Membrane ◽

Pure Tone Audiometry ◽

Complete Recovery ◽

Sudden Hearing Loss ◽

Tympanic Membrane Perforation ◽

Therapeutic Interventions ◽

Medical Sciences ◽

Accidental Trauma ◽

Membrane Perforation

Background: Tympanic membrane (TM) which forms the partition between external auditory canal and middle ear may be ruptured by trauma. Traumatic TM perforation is a commonly observed condition. Though, several therapeutic interventions have been described, conservative follow-up until spontaneous complete recovery is the most common choice.Methods: It was a prospective cohort study conducted during a period of 10 months from July 2020 to April 2021, carried out in 30 patients who presented to outpatient department of ENT and casualty of Hassan institute of medical sciences hospital with traumatic TM perforation. After taking informed consent, detailed history was taken, thorough examination of ear was performed and characteristics of perforation were noted. Pure tone audiometry (PTA) was conducted, data was statistically analysed.Results: Mean age group was 33.1 years and 73.3% were males. Ear pain was the commonest symptom with accidental trauma being the most common cause. 70% of them had left TM perforation and posteroinferior quadrant was mostly involved.Conclusions: Traumatic TM perforation is commonly seen in young adults following accidental trauma and assault. Earache, sudden hearing loss and tinnitus are the common symptoms. Most of the cases heal spontaneously with conservative management.

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En Hamac tympanoplasty and canalplasty for optimal type 1 tympanoplasty outcomes

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001383 ◽

2020 ◽

Vol 134 (9) ◽

pp. 769-772

Author(s):

S Vandenbroeck ◽

R Kuhweide ◽

B Lerut

Keyword(s):

Tympanic Membrane ◽

Tympanic Membrane Perforation ◽

Type 1 Tympanoplasty ◽

Tympanic Membrane Perforations ◽

Membrane Perforation ◽

The Mean ◽

Primary Type ◽

Optimal Type

AbstractObjectiveMultiple tympanoplasty techniques have been developed with numerous differences in grafting and approach. This study aimed to improve type 1 tympanoplasty outcomes by using the ‘en hamac’ technique as well as performing a complete canalplasty for anterior perforations.MethodA retrospective review was performed using the prospective Otology-Neurotology Database tool for otological surgery. All primary type 1 tympanoplasty cases performed for tympanic membrane perforations from 2010 to 2016 were selected for analysis, all performed by one author. Minimal clinical and audiometric follow up was 18 months.ResultsTympanic membrane perforation closure was achieved in 62 of the patients (96.88 per cent). None of the en hamac cases had residual or recurrent perforation (p = 0.02). The mean remaining air–bone gap was 8.50 dB. The remaining air–bone gap was less than 10 dB in 72.55 per cent, 10–20 dB in 25.49 per cent and more than 20 dB in 1.96 per cent.ConclusionUsing the en hamac technique for anterior perforations as well as systematically performing a complete canalplasty provides multiple surgical advantages with excellent post-operative results.

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