Ventilation Tubes and Prophylactic Antibiotic Eardrops

1992 ◽  
Vol 106 (2) ◽  
pp. 193-195 ◽  
Author(s):  
Ramzi T. Younis ◽  
Rande H. Lazar ◽  
Thomas E. Long

Insertion of ventilation tubes has successfully remedied chronic otitis media with effusion in millions of children, but the procedure has been complicated by secondary infections and otorrhea in as many as 34% of the cases. Because infection at the time of surgery was suspected as the primary cause of these postoperative complications, short-term prophylaxis with antibiotic eardrops was proposed for averting secondary infections. To evaluate this hypothesis, we conducted a 6-month prospective study in which 200 children had bilateral tube insertions. Antibiotic eardrops were administered to patients’ right ears intraoperatively and for 3 days after surgery; left ears received no eardrops and served as controls. The prophylactic strategy did not significantly decrease the incidence of postoperative otorrhea in treated right ears compared with controls.

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed A Mohammed ◽  
Tarek A Hamdy ◽  
Anas M Askoura ◽  
Ahmed M Abdulhakim

Abstract Background Otitis media with effusion (OME) is a worldwide major health problem for both children and adult, who have a history of chronic eustachian tube dysfunction. Aim of the Work to review the effect of intratympanic injection of steroids in treatment of chronic otitis media with effusion (persistent more than 3 months after failure to medical treatment [e.g. local & systemic steroids or decongestants] or surgical ventilation tubes). Material and Methods This systematic review was done as a collective analysis of 5 retrospective and prospective cohort studies done on patients with OME. Studies on Patients who were diagnosed with chronic otitis media with effusion not responding to conventional methods of treatment. Results The data analysed and results showed an improvement of 41.2% of the cases treated with intratympanic injection of steroids compared to 11% improvement in cases treated by conventional medical methods with a relative improvement around 6.4 folds to intratympanic injection of steroids over medical treatment. All of these studies have shown that there are more advantages of directed ototopical steroid therapy over systemic therapy. Topical medications often have limited systemic effects due to their limited systemic uptake. It may be less expensive as compared to systemic medications. Conclusion Intratympanic injection of long acting steroids has good effect in management of OME resistant to medical and surgical treatment and has superior effect and high rate of recovery on local nasal steroid spray. In children combination of ventilation tubes and intratymapnic injection of steroids is the best known modality of treatment. Further studies are needed to evaluate the best medical treatment of chronic OME.


2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Y. M. C. Gyebre ◽  
R. W.-L. Ouedraogo ◽  
A. Elola ◽  
B. P. Ouedraogo ◽  
M. Sereme ◽  
...  

Objectives. The aim of this study was to analyze the epidemiological and clinical aspects of chronic otitis media and its therapeutic processes in our context. Patients and Methods. In a prospective study over a period of 1 year (March 2009–February 2010), 79 patients with chronic otitis media have been cared for in the otolaryngology ward of the University Hospital of Ouagadougou. Results. Chronic otitis media (COM) commonly occurs in the age group from 0 to 15 years (40.50%). Otorrhea was the main reason for consultation in 53 cases (67.10%); the most frequently encountered clinicopathological forms were simple COM (71%) followed by otitis media with effusion (24.30%). Intra-auricular instillations of traditional products (46.09%) were the dominant favoring factor. Treatment was essentially through medication in 59 cases with a stabilization of lesions. Endotemporal complications were noticed in 6 cases. Conclusion. The fight against chronic otitis media is carried out through preventive measures of education the of people.


1990 ◽  
Vol 104 (8) ◽  
pp. 608-610 ◽  
Author(s):  
Eize W. J. Wielinga ◽  
Gordon D. L. Smyth

AbstractTreatment of otitis media with effusion is focused on reaeration of the middle ear cavity. In achieving longterm aeration, the insertion of ventilation tubes that have a long duration of stay can be beneficial. The results are presented of a trial in which the Goode T-tube was compared with the Armstrong tube. Fifteen children were treated between 1981 and 1986 with a T-tube in one ear and a conventional tube in the other. The results are different with regard to duration of stay in the tympanic membrane. Re-insertions were necessary in 47 per cent in the Armstrong group and in 20 per cent in the T-tube group. Otorrhoea occurred in 20 per cent of the Armstrong and 13 per cent of the T-tube intubated ears. A persistent perforation was present in 6 per cent of the ears in both groups. It is concluded that the Goode T-tube is indicated primarily in cases when long-term ventilation is needed.


2015 ◽  
pp. 173-177
Author(s):  
Minh Tri Ho ◽  
Thanh Thai Le

Otitis media and adenoid infection are popular with children. Chronic adenoid is considered as a cause to otitis media in children because infection in adenoid is likely to bring bacteria into middle ear through eustachian tube. Adenoidectomy is regarded as both a treatment measure and a prevention of complications caused by adenoid infection. Objectives: To find out any relations between otitis media and adenoid infection, eveluate the effectiveness of adenoidectomy in otitis media. Subjects and Methods: 54 patients with otitis media and adenoid infection that were diagnosed and treated at the University Hospital of the Faculty of Medicine and Pharmacy in Hue from Apr-2014 to Jun-2015. A descriptive, prospective study was conducted with clinical intervention. Results: There are relations between the frequency of adenoid infection and otitis media, yet no relations have been found between level of size of adenoidand otitis media. After adenoidectomy, 76.7% of the patients recovered from recurrent otitis media, 82.9% of the patients recovered from otitis media with effusion, 100% of the patients suffering with chronic otitis media got stable. Conclusion: There are relations between the frequency of adenoid infection and otitis media. The size of adenoid is not relevant to otitis media. Adenoidectomy has positive impact on the treatment of otitis media. Key words: Otitis media, adenoidectomy.


2001 ◽  
Vol 22 (3) ◽  
pp. 191-199 ◽  
Author(s):  
Maroeska M. Rovers ◽  
Huub Straatman ◽  
Koen Ingels ◽  
Gert-Jan van der Wilt ◽  
Paul van den Broek ◽  
...  

Author(s):  
Magdalena Beata Skarzynska ◽  
Elżbieta Gos ◽  
Natalia Czajka ◽  
Milaine Dominici Sanfis ◽  
Piotr Henryk Skarzynski

(1) Background: Otitis media with effusion (OME) is one of the most common diseases in childhood. The objective was to assess clinically the effectiveness of the surgical approach (tube insertion with adenoidectomy) in comparison with the non-surgical approach (watchful waiting) during a 12-month observation period. (2) Methods: This study was retrospective and obtained approval from the bioethics committee. The criteria of inclusion in the first group (surgical approach) were: (1) a diagnosis of chronic otitis media with effusion in children aged between 1 and 6 years; (2) their medical history showed that they had undergone adenoidectomy and tympanostomy with the insertion of ventilation tubes (VTs). The criteria for inclusion in the second group (non-surgery) were similar to the first group except that their medical history showed they had not undergone adenoidectomy or tympanostomy with the insertion of VTs. There were 422 children included in the surgical group and 50 children in the non-surgical group, and the period of observation was 12 months. (3) Results: For the entire surgical group, the number of healthy days ranged from 20 to 365, with a mean of 328.0 days (SD = 91.4).In the non-surgical group, the number of healthy days ranged from 13 to 365, with a mean of 169.2 days (SD = 127.3). The difference in the number of healthy days was statistically significant (p < 0.001). The certainty of treatment in the first group was higher than in the second group, and the number of days without recurrence was significantly higher than in the second group. In the first group, there were 71 recurrences from 422 children (16.8%), and, in the second subgroup, there were 40 recurrences of acute otitis media (AOM) from 50 children (80%). The RR was 0.21. (4) Conclusions: The surgical approach in children aged 1–6 years who have been diagnosed with otitis media with effusion is reasonable and beneficial for the child.


1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 49-53 ◽  
Author(s):  
Michael M. Paparella ◽  
Oleg Froymovich

Surgical methods of treating otitis media and its sequelae are discussed, according to the classification of otitis media presented in an earlier report Surgical management of otitis media with effusion and recurrent purulent otitis media includes myringotomy and use of ventilation tubes. Occasionally, otitis media with effusion will lead to structural and other pathologic changes in the middle ear, and conservative treatments such as use of medication or tubes will not suffice. Indications and methods for exploratory tympanotomy and reconstruction of the middle ear are discussed. In such instances, tympanoplasty can be used to the patient's benefit Chronic otitis media with mastoiditis, defined by the presence of intractable pathologic tissue, generally requires surgical correction. Classic methods include simple mastoidectomy, modified radical (Bondy) mastoidectomy, and radical mastoidectomy. Current classifications of procedures would also include closed-cavity tympanomastoidectomy, open-cavity tympanomastoidectomy, and intact-bridge tyrnpanomastoidectomy (a combined approach). The diagnostic and surgical approach to silent or subclinical otitis media is discussed. Diagnosis and treatment of sequelae of otitis media, including sequelae in the middle ear and, less commonly, in the inner ear, are discussed.


2021 ◽  
pp. 000348942110157
Author(s):  
Jennifer L. McCoy ◽  
Ronak Dixit ◽  
R. Jun Lin ◽  
Michael A. Belsky ◽  
Amber D. Shaffer ◽  
...  

Objectives: Extensive literature exists documenting disparities in access to healthcare for patients with lower socioeconomic status (SES). The objective of this study was to examine access disparities and differences in surgical wait times in children with the most common pediatric otolaryngologic surgery, tympanostomy tubes (TT). Methods: A retrospective cohort study was performed at a tertiary children’s hospital. Children ages <18 years who received a first set of tympanostomy tubes during 2015 were studied. Patient demographics and markers of SES including zip code, health insurance type, and appointment no-shows were recorded. Clinical measures included risk factors, symptoms, and age at presentation and first TT. Results: A total of 969 patients were included. Average age at surgery was 2.11 years. Almost 90% were white and 67.5% had private insurance. Patients with public insurance, ≥1 no-show appointment, and who lived in zip codes with the median income below the United States median had a longer period from otologic consult and preoperative clinic to TT, but no differences were seen in race. Those with public insurance had their surgery at an older age than those with private insurance ( P < .001) and were more likely to have chronic otitis media with effusion as their indication for surgery (OR: 1.8, 95% CI: 1.2-2.5, P = .003). Conclusions: Lower SES is associated with chronic otitis media with effusion and a longer wait time from otologic consult and preoperative clinic to TT placement. By being transparent in socioeconomic disparities, we can begin to expose systemic problems and move forward with interventions. Level of Evidence: 4


2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Rebecca E. Walker ◽  
Jim Bartley ◽  
David Flint ◽  
John M. D. Thompson ◽  
Edwin A. Mitchell

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