Prompt insertion of tympanostomy tubes in infants and toddlers with persistent middle ear effusion did not improve developmental outcomes at 9-11 years of age

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.

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Middle ear effusion: rate and risk factors in Australian children attending day care

Epidemiology and Infection ◽

10.1017/s0950268899002708 ◽

1999 ◽

Vol 123 (1) ◽

pp. 57-64 ◽

Cited By ~ 11

Author(s):

S. A. SKULL ◽

P. S. MORRIS ◽

A. YONOVITZ ◽

R. G. ATTEWELL ◽

V. KRAUSE ◽

...

Keyword(s):

Risk Factors ◽

Middle Ear ◽

Day Care ◽

Clinical Importance ◽

Speech Development ◽

Effusion Rate ◽

Middle Ear Effusion ◽

Tympanostomy Tubes ◽

History Of ◽

Ear Effusion

There have been no previous longitudinal studies of otitis media conducted in non-Aboriginal Australian children. This paper describes the rate and risk factors for middle ear effusion (MEE) in children attending day care in Darwin, Australia. A prospective cohort study of 252 children under 4 years was conducted in 9 day care centres over 12 fortnights between 24 March and 15 September 1997. Tympanometry was conducted fortnightly and multivariate analysis used to determine risk factors predicting MEE. The outcome of interest was the rate of type B tympanograms per child detected in either ear at fortnightly examinations. After adjusting for clustering by child, MEE was detected on average 4·4 times in 12 fortnights (37% of all examinations conducted). Risk factors associated with presence of effusion were younger age, a family history of ear infection, previous grommets (tympanostomy tubes), ethnicity and the day care centre attended. A history of wheeze appeared protective. These effects were modest (RR 0·57–1·70). Middle ear effusion is very common in children attending day care in Darwin. This has clinical importance, since MEE during early childhood may affect optimal hearing, learning and speech development. There is little scope for modification for many of the risk factors for MEE predicted by this model. Further study of the day care environment is warranted.

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Pharmacokinetics of Cefaclor in Chronic Middle Ear Effusions

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894810903s211 ◽

1981 ◽

Vol 90 (3_suppl2) ◽

pp. 44-47 ◽

Cited By ~ 9

Author(s):

Torben Lildholdt ◽

Charles D. Bluestone ◽

Erdem I. Cantekin ◽

Dale D. Rohn ◽

Gabriel Marshak ◽

...

Keyword(s):

Middle Ear ◽

Otitis Media With Effusion ◽

Peak Level ◽

Oral Route ◽

Diffusion Method ◽

Aerobic Bacteria ◽

Middle Ear Effusion ◽

Disk Diffusion Method ◽

Tympanostomy Tubes ◽

Ear Effusion

Fifty children aged 1 to 13 years with chronic or recurrent otitis media with effusion received a single dose of cefaclor (15 mg/kg body weight) by the oral route 30 minutes to seven hours before the removal of middle ear effusion and insertion of tympanostomy tubes. Serum and middle ear aspirate concentrations of the antibiotic were determined employing a microbiological assay technique by a disk diffusion method. Middle ear specimens were also cultured for aerobic bacteria. The mean peak serum concentration level (8.49± 7.89 μg/ml) was observed after 30 minutes, whereas the middle ear peak level (0.47± 0.78 μg/ml) occurred after one hour. Of the 87 middle ear specimens, 37 had cefaclor concentrations which were detectable within the resolution of the bioassay method (>0.16 μg/ml). There was no correlation between the type of middle ear effusion (mucoid or serous) and the concentration of cefaclor in the middle ear. Only 18% of the middle ear cultures were positive for aerobic bacteria; Hemophilus influenzae was the most common organism.

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In Reply: Dry Myringotomies and Impedance Testing

PEDIATRICS ◽

10.1542/peds.61.1.152a ◽

1978 ◽

Vol 61 (1) ◽

pp. 152-153

Author(s):

Jack L. Paradise ◽

Clyde C. Smith ◽

Charles D. Bluestone

Keyword(s):

Middle Ear ◽

Middle Ear Effusion ◽

Tympanostomy Tubes ◽

Impedance Testing ◽

Ear Effusion

The first issue raised by Gordon—the "problem of the [unexpectedly] dry myringotomy" suggests a misreading of the stated conditions of our study. The subjects were not our patients, but were patients whose cases were being managed by other physicians who allowed us to study them. And the diagnostic assessments—both otoscopic and tympanometric—were carried out immediately preoperatively. Thus few of the "dry taps" were unexpected: rightly or wrongly, most of them were performed knowingly in order to insert tympanostomy tubes in an effort to prevent recurrence of acute otitis media1 rather than to remove middle ear effusion.

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

The Journal of Laryngology & Otology ◽

10.1017/s002221510013230x ◽

1995 ◽

Vol 109 (12) ◽

pp. 1151-1154 ◽

Cited By ~ 6

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.

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

PEDIATRICS ◽

10.1542/peds.53.1.48 ◽

1974 ◽

Vol 53 (1) ◽

pp. 48-54 ◽

Cited By ~ 1

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.

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

The Laryngoscope ◽

10.1002/lary.28860 ◽

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

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Tympanostomy Tubes: Do They Significantly Benefit the Patient

Otolaryngology ◽

10.1177/019459988209000619 ◽

1982 ◽

Vol 90 (6) ◽

pp. 783-786 ◽

Cited By ~ 22

Author(s):

Gordon D.L. Smyth ◽

Christopher C. Patterson ◽

Samuel Hall

Keyword(s):

Retrospective Study ◽

Randomized Trial ◽

Success Rate ◽

Middle Ear ◽

Middle Ear Effusion ◽

Short Term ◽

Tympanostomy Tubes ◽

Ear Effusion ◽

Ventilator Tube

To gain more information about the role of tympanostomy tubes in the treatment of chronic middle ear effusion, the authors conducted a randomized trial that clearly indicated the short-term advantages of combining the insertion of an Armstrong ventilator tube with paracentesis and fluid aspiration over paracentesis and aspiration alone. A retrospective study of the success rate with three types of tympanostomy tubes (Shepard, Armstrong, and Paparella) was also carried out. The Armstrong tube had the highest success rate.

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