Feasibility of an Innovative Absorbable Ventilation Tube Designed to Provide Intermediate-Term Middle Ear Ventilation

2021 ◽  
pp. 019459982110265
Author(s):  
Sandra Skovlund ◽  
Shelagh Cofer ◽  
Heather Weinreich
Keyword(s):  
Tympanic Membrane ◽  
Feasibility Study ◽  
Middle Ear ◽  
Surgical Procedure ◽  
Therapeutic Response ◽  
Tube Placement ◽  
Proof Of Concept ◽  
Ventilation Tube ◽  
Middle Ear Ventilation ◽  
Duration Of Ventilation

Myringotomy with ventilation tube placement is a common surgical procedure performed in children and adults to remove fluid buildup behind the tympanic membrane. However, retention of tubes beyond achievement of therapeutic response increases risk for complications and additional intervention. This small feasibility study was conducted to demonstrate proof of concept of a novel bioabsorbable ventilation tube that provides the necessary duration of ventilation with absorption shortly thereafter. Tubes were placed in 15 ears of 14 patients meeting indications for short or intermediate duration of middle ear ventilation. Two independent examiners documented tube patency and tube absorption status at 3, 6, and 12 weeks or until absorption was complete. Results indicate that average ventilation time was 12 weeks (range, 3 weeks to 18 months). There was no observation of blockage. These findings support the feasibility of a novel bioabsorbable ventilation tube.

scholarly journals Feasibility of an Innovative Absorbable Ventilation Tube Designed to Provide Intermediate-Term Middle Ear Ventilation: Clinical Human Proof-of-Concept

2021 ◽  
Author(s):  
Sandra M Skovlund ◽  
Shelagh Cofer ◽  
Heather Weinreich
Keyword(s):  
Tympanic Membrane ◽  
Feasibility Study ◽  
Middle Ear ◽  
Surgical Procedure ◽  
Therapeutic Response ◽  
Tube Placement ◽  
Proof Of Concept ◽  
Ventilation Tube ◽  
Middle Ear Ventilation ◽  
Duration Of Ventilation

Myringotomy with ventilation tube placement is a common surgical procedure performed in children and adults to remove fluid build-up behind the tympanic membrane. However, retention of tubes beyond achievement of therapeutic response increases risk for complications and additional intervention. This small feasibility study was conducted to demonstrate proof-of-concept of a novel bioabsorbable ventilation tube (BVT) that provides the necessary duration of ventilation with absorption shortly thereafter in human adult patients. BVTs were placed in 15 ears of 14 patients meeting indications for short or intermediate-duration of middle ear ventilation. Two independent examiners documented eardrum status. BVT patency and BVT absorption status at 3, 6, and 12 week intervals until absorption was complete. Results indicate that average ventilation time was 12 weeks (range 3 weeks to 18 months). There was no observation of blockage. These findings support the safety and utility of a novel bioabsorbable ventilation tube.

scholarly journals External ear canal cholesteatoma after ventilation tube insertion and mastoidectomy

2012 ◽  
Vol 69 (4) ◽  
pp. 363-366 ◽  
Author(s):  
Dragoslava Djeric ◽  
Milan Jovanovic ◽  
Ivan Baljosevic ◽  
Srbislav Blazic ◽  
Milanko Milojevic
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Membrane Surface ◽  
Tube Placement ◽  
External Ear ◽  
Ventilation Tube ◽  
Ear Canal ◽  
Tube Insertion ◽  
Tissue Mass ◽  
External Ear Canal

Introduction. Etiopathogenetically, there are two types of chollesteatomas: congenital, and acquired. Numerous theories in the literature try to explain the nature of the disease, however, the question about cholesteatomas remain still unanswered. The aim of the study was to present a case of external ear canal cholesteatoma (EEC) developed following microsurgery (ventilation tube insertion and mastoidectomy), as well as to point ant possible mechanisms if its development. Case report. A 16-yearold boy presented a 4-month sense of fullness in the ear and otalgia on the left side. A year before, mastoidectomy and posterior atticotomy were performed with ventilation tube placement due to acute purulent mastoiditis. Diagnosis was based on otoscopy examination, audiology and computed tomography (CT) findings. CT showed an obliterative soft-tissue mass completely filled the external ear canal with associated erosion of subjacent the bone. There were squamous epithelial links between the canal cholesteatoma and lateral tympanic membrane surface. They originated from the margins of tympanic membrane incision made for a ventilation tube (VT) insertion. The position of VT was good as well as the aeration of the middle ear cavity. The tympanic membrane was intact and of normal appearance without middle ear extension or mastoid involvement of cholesteatoma. Cholesteatoma and ventilation tube were both removed. The patient recovered without complications and shortly audiology revealed hearing improving. Follow-up 2 years later, however, showed no signs of the disease. Conclusion. There could be more than one potential delicate mechanism of developing EEC in the ear with VT insertion and mastoidectomy. It is necessary to perform routine otologic surveillance in all patients with tubes. Affected ear CT scan is very helpful in showing the extent of cholesteatoma and bony defects, which could not be assessed by otoscopic examination alone.

Bacterial biofilm adherence to middle-ear ventilation tubes: scanning electron micrograph images and literature review

2007 ◽  
Vol 121 (10) ◽  
pp. 993-997 ◽  
Author(s):  
M Barakate ◽  
E Beckenham ◽  
J Curotta ◽  
M da Cruz
Keyword(s):  
Middle Ear ◽  
Bacterial Biofilm ◽  
Electron Micrograph ◽  
Ventilation Tube ◽  
Scanning Electron Micrograph ◽  
Chronic Infections ◽  
Middle Ear Ventilation ◽  
Conventional Antibiotics ◽  
Scanning Electron

Introduction: The organisms that cause many device-related and other chronic infections actually grow in biofilms in or on these devices. We sought to examine the role of biofilm formation in chronic middle-ear ventilation tube infection.Case report: Scanning electron micrograph images are presented which demonstrate biofilm on a middle-ear ventilation tube removed from a five-year-old child's chronically discharging ear. A review of the relevant international literature explores the role of biofilms in chronic infection and discusses potential intervention strategies.Conclusion: Biofilms may be responsible for chronic middle-ear ventilation tube infection that resists treatment with conventional antibiotics.

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.

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

The effect of changes in ambient oxygen concentration on the bioelectric properties of middle ear mucosa

2003 ◽  
Vol 285 (3) ◽  
pp. C618-C622 ◽  
Author(s):  
David L. Mandell ◽  
Daniel C. Devor ◽  
Joseph V. Madia ◽  
Chia-Yee Lo ◽  
Hilary Hake ◽  
...  
Keyword(s):  
Middle Ear ◽  
Tube Placement ◽  
Channel Blockade ◽  
Ventilation Tube ◽  
Middle Ear Mucosa ◽  
Cell Monolayers ◽  
Physiological Conditions ◽  
Ambient Oxygen ◽  
Epithelial Cell Monolayers ◽  
Stimulation Of

The purpose of the present study was to compare the effect of 24 h of exposure to 7% O2 (normal middle ear physiological conditions) vs. 21% O2 (found in the middle ear after ventilation tube placement) on transepithelial Na+ absorption and Cl– secretion in cultured gerbil middle ear epithelial cell monolayers. Although no difference in apical Na+ absorption was identified, the UTP-induced stimulation of apical Cl– secretion in the presence of apical Na+ channel blockade with amiloride was significantly enhanced after exposure to 21% O2 compared with 7% O2 exposure. In the presence of a calcium-activated Cl– channel inhibitor, DIDS, UTP-induced stimulation of Cl– secretion after 21% O2 exposure was decreased, suggesting a role for calcium-activated Cl– channels in middle ear Cl– secretion in response to relative hyperoxia.

Increasing rate of middle ear ventilation tube insertion in children in denmark

2014 ◽  
Vol 78 (9) ◽  
pp. 1541-1544 ◽  
Author(s):  
Bjarki Ditlev Djurhuus ◽  
Axel Skytthe ◽  
Kaare Christensen ◽  
Christian Emil Faber
Keyword(s):  
Middle Ear ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Middle Ear Ventilation

scholarly journals Approaches to a Successful Myringoplasty – Which Factors Make a Myringoplasty Difficult?

2021 ◽  
Vol 29 (1) ◽  
pp. 72-85
Author(s):  
Wendy Smith ◽  
Swagatam Banerjee
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Surgical Procedure ◽  
Otitis Externa ◽  
Surgical Team ◽  
Factors Affecting ◽  
Pearl Formation ◽  
Primary Author

Abstract Introduction Myringoplasty has often been viewed as a “basic” ENT procedure. This paper will discuss the factors that can make a myringoplasty more challenging and suggest some techniques to overcome these. Affecting FactorsPatient factorsThe age of the patient, their habitus and co-existing co-morbidities are usually the factors affecting the choice and outcome of the procedure. The earAnatomical variations, the nature of the pathology itself and the condition of the remnant tympanic membrane and the middle ear are important factors for consideration. Other factorsEquipment availability, expertise of the surgical team and anaesthetic support can also influence the surgical procedure. Surgical ProcedureThe actual procedure can be done in a variety of ways including but not limited to different approaches, different techniques and using different equipment like microscopes, endoscopes, LASER, etc.Results and ComplicationsThe primary author reported a success rate of about 95% in her series. Complications of myringoplasty include myringitis, residual perforations, otitis externa and epithelial pearl formation.

scholarly journals Ear Findings in Post Surgical Cleft Palate Patients

2019 ◽  
Vol 4 (1) ◽  
pp. 621-624
Author(s):  
Sanjeev Kumar Thakur ◽  
Baleshwar Yadav ◽  
Raj Kumar Bedajit ◽  
Kailash Khaki Shrestha ◽  
Shankar Man Rai
Keyword(s):  
Cleft Palate ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Otitis Media With Effusion ◽  
Low Correlation ◽  
Middle Ear Ventilation ◽  
Tube Dysfunction ◽  
History Of

Introduction: Cleft lip and palate is one of the most common congenital anomaly, which contributes to eustachian tube dysfunction leading to impaired middle ear ventilation and middle ear pathology. It has been stated that the timely repair of cleft palate reduces the incidence of otitis media with effusion. Objective: To describe the ear findings in cleft palate patients who have undergone repair of cleft palate. Methodology: A total of 36 (20 male and 16 female) post cleft repair patients underwent Otoscopy and Tympanometry between January to December 2018. Cases with isolated cleft lip, ears with perforation of tympanic membrane and attico-antral disease were excluded. Results: The age range was from 4 years to 24 years, with a mean of 11.34 years. Maximum patients were of the age group of 10- 20 years (18, 50%) followed by that of 5-10 years range (15, 41.66%). Total number of ears examined were 72. Out of a total of 72 ears, 70 (97.2%) had abnormal otoscopic finding with dull tympanic membrane in 37 (51.39%) ears, retracted in 31 (43.05%) and bulging tympanic membrane in 2 (2.78%) cases. Type B curve was the commonest (36, 50%), followed by Type As (24, 33.3%). Type C curve was found in 11(15.3%) ears. Type A curve was found only in one ear. The duration of post-repair of cleft palate ranged from 6 months to up to 16 years with a mean of 8.52; 11 cases(30.56%) had history of repair of cleft palate of more than 10 years duration.16 cases (44.44%) had that of more than 5 years and 9 cases (25%) had less than 5 years history of duration of repair. When correlation was done statistically, the tympanometry findings and duration of repair had a very low correlation (Table 5). The time period of repair had no significant effect on tympanometric ear findings. Conclusion Abnormal otoscopic findings and tympanometric findings were common in post cleft palate repaired patients. The duration of cleft palate repair had low correlation to the tympanometric ear findings.

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