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.

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.

Otitis Media, Cleft Palate, and Middle Ear Ventilation

1981 ◽  
Vol 89 (2) ◽  
pp. 288-293 ◽  
Author(s):  
William L. Meyerhoff ◽  
Donald A. Shea ◽  
Craig A. Foster
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Tympanostomy Tube ◽  
Middle Ear Effusion ◽  
Tympanostomy Tubes ◽  
Middle Ear Ventilation ◽  
Ear Effusion

Chinchillas with unilateral tympanostomy tubes in place underwent palate-clefting in an effort to determine the histologic and bacteriologic effects of using tympanostomy tubes in the treatment of otitis media. The tympanostomy tube appeared to almost totally eliminate the occurrence of middle ear effusion but had much less, if any, effect on eliminating the middle ear inflammation which occurs in the clefted chinchilla.

Nonsurgical Management of Otitis Media with Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 301-302 ◽  
Author(s):  
G. Howard Gottschalk
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Medical Management ◽  
Otitis Media With Effusion ◽  
Middle Ear Effusion ◽  
Nonsurgical Management ◽  
Middle Ear Ventilation ◽  
Ventilation Tubes ◽  
Proper Diagnosis ◽  
Ear Effusion

Otitis media with effusion can be successfully treated without the use of middle ear ventilation tubes. Middle ear inflation will, if performed properly, empty most ears as effectively as direct suction through a myringotomy incision. Over 12,000 patients with middle ear effusion have responded to conservative treatment which includes medical management aided by middle ear inflations using a modification of the classic politzerization technique. The technique of controlled middle ear inflation is described and the proper medical management discussed. The avoidance of oral decongestants is stressed as is the proper diagnosis and treatment of the etiological factors causing the formation of the fluid.

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.

EARLY TREATMENT OF THE UNIVERSAL OTITIS MEDIA OF INFANTS WITH CLEFT PALATE

PEDIATRICS ◽  
1974 ◽  
Vol 53 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Jack L. Paradise ◽  
Charles D. Bluestone
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Intellectual Development ◽  
Middle Ear Effusion ◽  
Suppurative Otitis Media ◽  
Tympanostomy Tubes ◽  
Palate Repair ◽  
Ear Effusion

In 138 infants with cleft palate, secretory or suppurative otitis media was a universal complication. Middle ear aeration was instituted by means of myringotomy, aspiration of middle ear liquid, and insertion of tympanostomy tubes, and this procedure was repeated whenever recurrence of middle ear effusion followed blockage or extrusion of the tubes. In infants with either complete or incomplete clefts of the palate, satisfactory middle ear status could usually be maintained. Otorrhea through tympanostomy tubes occurred frequently, but usually responded promptly to treatment. Palate repair resulted in sharp improvement in middle ear status. Early relief of middle ear effusion anti establishment and maintenance of middle ear aeration in infants with cleft palate may help maintain normal hearing acuity throughout infancy, with favorable implications for language and intellectual development, and may reduce the risk of permanent middle ear damage and hearing impairment. Further study is necessary to determine the long-term efficacy of this regimen.

Long‐term Impact of Middle Ear Effusion in Pediatric Tympanostomy Tubes

2020 ◽  
Author(s):  
Thomas M. Kaffenberger ◽  
Michael A. Belsky ◽  
Nicholas R. Oberlies ◽  
Aarti Kumar ◽  
Joseph P. Donohue ◽  
...  
Keyword(s):  
Middle Ear ◽  
Middle Ear Effusion ◽  
Tympanostomy Tubes ◽  
Long Term Impact ◽  
Ear Effusion

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.

Possible Long-Term Consequences of Middle Ear Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 246-248 ◽  
Author(s):  
Denzil N. Brooks
Keyword(s):  
Middle Ear ◽  
Hearing Aids ◽  
The Elderly ◽  
Middle Ear Effusion ◽  
Surgical Interventions ◽  
Impedance Testing ◽  
Auditory Impairment ◽  
Ear Effusion

Three studies will be reported in this paper and the suggestion made that there may be a connection between the findings. The first study concerns the middle ear status of 48 children treated in 1966/67 for middle ear effusion and followed up after ten years. Prior to treatment the median HL was 20 dB (SD = 13 dB) and at follow-up the median HL was 8 dB (SD = 5 dB). However, the otologic and tympanometric findings were less encouraging. Abnormal tympanic membranes (TM) were observed in almost half the children, the rate of abnormality relating to the number of surgical interventions made. However, the TM changes may be due either to the treatment or the disease itself. The second study concerns 104 children monitored by impedance testing over a ten-year period and tends to support the hypothesis that the effusion itself is the probable cause of the changes in the TM. The third study relates to applicants for hearing aids. Excluding those with clearly defined conditions such as otosclerosis, noise trauma and Meniére's disorder, etc, two clear groups emerged, one with uncontaminated sensorineural (SN) loss, the other with mainly SN loss but with a significant conductive overlay. Though the median hearing losses of the two groups are the same, the average age for the SN group (77; SD = 7 years) is 12 years greater than that of the “conductive” group (65; SD = 14 years). Few of the SN group can recall auditory dysfunction in childhood, but the majority of the conductive group have clear recall. It seems probable that middle ear disorders in childhood may give rise to auditory impairment in the elderly such that when combined with age-associated hearing loss the need for prosthetic aid arises at a much lower age.

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