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.

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.

scholarly journals A Long-term Follow-up Study of Middle Ear Surgery

1981 ◽  
Vol 74 (5special) ◽  
pp. 913-920
Author(s):  
Kotaro Ukai ◽  
Yasuro Miyoshi ◽  
Yasuo Sakakura ◽  
Mikikazu Yamagiwa ◽  
Yuichi Majima ◽  
...  
Keyword(s):  
Middle Ear ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Follow Up Study ◽  
Long Term Follow Up

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.

Prolonged Middle Ear Ventilation: The Right Tube in the Right Place

1983 ◽  
Vol 92 (6) ◽  
pp. 582-586 ◽  
Author(s):  
B. W. Armstrong
Keyword(s):  
Middle Ear ◽  
Suction Device ◽  
Small Incision ◽  
Middle Ear Ventilation ◽  
Ventilating Tubes ◽  
Tube Migration ◽  
Insertion Tool ◽  
Long Term Ventilation ◽  
The Right

Premature extrusion of ventilating tubes continues to plague both doctor and patient. Migrating epithelium on the lateral surface of the drum has been identified as the principal cause of tube migration and extrusion. This information dictates insertion of a tube in an area where the migrating forces tend to keep the tube in place instead of encouraging rejection. When optimally placed, tubes specifically designed for long-term ventilation will function four times longer than randomly placed conventional tubes. The long-term ventilating tube in use since 1965 has been further refined. A notch and tab on the tube mate with a new inserter/suction device, and this combination permits precise placement through a small incision without tilting and twisting during insertion. Suction may be applied as desired to clear the lumen as the insertion tool is withdrawn.

scholarly journals The Middle Ear in Cleft Palate Children Pre and Post Palatal Closure

1988 ◽  
Vol 81 (12) ◽  
pp. 710-713 ◽  
Author(s):  
R S Dhillon
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Prospective Trial ◽  
Ventilation Tube ◽  
Long Term Ventilation ◽  
Palatal Surgery

A multicentre prospective trial was commenced in July 1984 to establish the incidence of otitis media with effusion (OME) in children born with a cleft of the palate. Additionally, the data recorded would allow an assessment of the effect of palatal closure on middle ear function. Prior to palatal closure, 97% of ears in a group of 50 patients had otitis media with effusion (OME). The insertion of a long-term ventilation tube provided a means of aeration of one ear with the non-ventilated ear acting as a control. Eighty percent of control ears had persistent OME during a 24-month follow-up period post palatal repair. It would seem that OME is universally present in children with a cleft palate prior to 4 months of age and this incidence is only marginally diminished by palatal surgery. The liaison between plastic surgical and ENT units should be even closer than before in order to manage these patients satisfactorily.

Long-term ventilation of the middle ear using the Goode T-Tube

1985 ◽  
Vol 99 (4) ◽  
pp. 335-337 ◽  
Author(s):  
M. P. Rothera ◽  
H. R. Grant
Keyword(s):  
Middle Ear ◽  
T Tube ◽  
Long Term Ventilation

Incus Interposition

1983 ◽  
Vol 92 (6) ◽  
pp. 568-570 ◽  
Author(s):  
Claude L. Pennington
Keyword(s):  
Middle Ear ◽  
Postoperative Care ◽  
Follow Up Study

A 10- to 15-year follow-up study of patients with modeled incus interposition procedure for restoration of hearing reveals that hearing gains as reported in 1972 were sustained by long-term postoperative care despite resurgence of problems from negative middle ear air pressures.

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