Current Evidence for Simulation-Based Training and Assessment of Myringotomy and Ventilation Tube Insertion

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lisette Hvid Hovgaard ◽  
Fahd Al-Shahrestani ◽  
Steven Arild Wuyts Andersen
Keyword(s):  
Current Evidence ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Simulation Based

Should we aspirate middle-ear effusions prior to insertion of ventilation tubes?

2006 ◽  
Vol 120 (10) ◽  
pp. 818-821 ◽  
Author(s):  
V Laina ◽  
D D Pothier
Keyword(s):  
Middle Ear ◽  
Acoustic Trauma ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Central Register ◽  
Increased Risk ◽  
Ventilation Tubes ◽  
Review Current

Background: Routine aspiration of middle-ear effusions prior to ventilation tube (grommet) insertion is practised by many surgeons. It has been suggested that removing the fluid from the middle ear improves immediate post-operative hearing levels and reduces the chance of the ventilation tube becoming obstructed. The potential adverse effects of applying suction to the middle ear include acoustic trauma and an increased risk of tympanosclerosis and otorrhoea. We undertook a review of the literature in order to determine the benefits or side effects associated with middle-ear aspiration prior to ventilation tube insertion.Objectives: To compare clinical outcomes associated with aspirating versus not aspirating the middle ear prior to ventilation tube insertion.Methods: The Cochrane ENT group trials register, DARE, the Cochrane central register of controlled trials (CENTRAL), MEDLINE (1960–2005) and EMBASE (1960–2005) were searched using relevant terms. Reference lists of selected studies were scanned for additional research material.Results: Seven studies were identified, of which three fitted the inclusion criteria of our review. Current evidence suggests that aspiration of middle-ear effusions prior to insertion of ventilation tubes is not associated with any improvement in clinical outcome, in terms of post-operative hearing levels, otorrhoea or rates of blockage of ventilation tubes. Significantly increased rates of tympanosclerosis were observed in one study and the development of acoustic trauma was observed; however, no significant association was confirmed. Although more research is needed, there is no evidence that aspiration of middle-ear effusion prior to grommet insertion confers any advantage.

Multifrequency multicomponent tympanometry in children with a history of ventilation tube insertion

2021 ◽  
pp. 110798
Author(s):  
Sule Kaya ◽  
Kemal Keseroglu ◽  
Sibel Alicura Tokgoz ◽  
Elife Barmak ◽  
Guleser Saylam ◽  
...  
Keyword(s):  
Ventilation Tube ◽  
Tube Insertion ◽  
History Of

Simple model for teaching myringotomy and aural ventilation tubeinsertion

1998 ◽  
Vol 112 (7) ◽  
pp. 642-643 ◽  
Author(s):  
A. O. Owa ◽  
R. W. R. Farrell
Keyword(s):  
Simple Model ◽  
Simple Solution ◽  
Ventilation Tube ◽  
Ear Canal ◽  
Tube Insertion ◽  
Limited Supply ◽  
Temporal Bones

AbstractAural ventilation tube insertion is the most common otological operation and is usually the first operation learnt by trainees. The limited supply of temporal bones as well as expensive commercial models hampers training in the procedure. This paper describes a simple solution making a model of the ear canal and drum out of materials available on an ENT ward.

scholarly journals Regional and hospital variation in commonly performed paediatric otolaryngology procedures in the Netherlands: a population-based study of healthcare utilisation between 2016 and 2019

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046840
Author(s):  
Juliëtte J C M van Munster ◽  
Joost J G Wammes ◽  
Rolf H Bremmer ◽  
Amir H Zamanipoor Najafabadi ◽  
Raphael J Hemler ◽  
...  
Keyword(s):  
The Netherlands ◽  
Healthcare Utilisation ◽  
Care Process ◽  
Resource Utilisation ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
High Quality ◽  
Cross Sectional ◽  
Referral Rates ◽  
Hospital Variation

ObjectiveIn the past few decades, there has been an increase in high-quality studies providing evidence on the effectiveness of commonly performed procedures in paediatric otolaryngology. We believe that now is the time to re-evaluate the care process. We aimed to analyse (1) the regional variation in incidence and referrals of adenoidectomies, tonsillectomies and ventilation tube insertions in children in the Netherlands between 2016 and 2019, (2) whether regional surgical rates, referral rates and in-hospital surgical rates were associated with one another, and (3) the hospital variation in healthcare costs, which indicates the utilisation of resources.DesignRepeated cross-sectional analysis.SettingFour neighbouring Dutch provinces comprising 2.8 million inhabitants and 14 hospitals.ParticipantsChildren aged 0–15 years.Outcome measuresWe analysed variation in regional surgical rates and referral rates per 1000 inhabitants and in-hospital surgical rates per 1000 clinic visitors, adjusted for age and socioeconomic status. Furthermore, the relationships between referral rates, regional surgical rates and in-hospital surgical rates were estimated. Lastly, variation in resource utilisation between hospitals was estimated.ResultsAdenoidectomy rates differed sixfold between regions. Twofold differences were observed for adenotonsillectomy rates, ventilation tube insertion rates and referral rates. Referral rates were negatively associated with in-hospital surgical rates for adenotonsillectomies, but not for adenoidectomies and ventilation tube insertions. In-hospital surgical rates were positively associated with regional rates for adenoidectomies and adenotonsillectomies. Significant variation between hospitals was observed in costs for all resources.ConclusionsWe observed low variation in tonsillectomies and ventilation tube insertion and high variation in adenoidectomies. Indications for a tonsillectomy and ventilation tube insertion are well defined in Dutch guidelines, whereas this is not the case for an adenoidectomy. Lack of agreement on indications can be expected and high-quality effectiveness research is required to improve evidence-based guidelines on this topic.

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