scholarly journals Clinical study and post operative outcomes of tympanostomy tube insertion in otitis media with effusion

Author(s):  
Ashutosh S. Kumar ◽  
Gundappa D. Mahajan ◽  
James Thomas ◽  
Tejal A. Sonar

<p class="abstract"><strong>Background:</strong> Otitis media with effusion (OME) is defined as the presence of a middle ear effusion in the absence of infection. Fluid in the middle ear is associated most commonly with a conductive hearing loss and an increased risk of acute middle ear infection. It can have an impact on quality of life. The objective of our study was to assess symptomatology of OME, study complications following tympanostomy tube insertion in OME and to highlight the age, sex distribution of otitis media with effusion.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted in Department of Otorhinolaryngology, Dr. D. Y. Patil Medical College and Hospital, Pimpri, Pune from October 2017 to March 2019. 50 ears of patients aged between 6 to 50 years with OME were included in the study. All the patients were observed for symptomatology and postoperative complications who underwent Tympanostomy tube insertion.  </p><p class="abstract"><strong>Results:</strong> OME is commoner in children and adolescents with no gender preponderance. The most common otoscopic findings pre-operatively included dull lustreless amber colored tympanic membrane in 56% (n=28), Retracted Tympanic Membrane and for shortened handle of malleus in 28% (n=14), air bubbles were seen in 12% (n=6) whereas fluid level was seen in 4% (n=2). Common complications post operatively included myringosclerosis and tympanic membrane atelectasis seen in 10% and 6% respectively.</p><p class="abstract"><strong>Conclusions:</strong> Tympanostomy tube insertion is one of the ideal treatments in management of otitis media with effusion, most commonly affecting younger age groups, with fewer complications, which can lead to a better quality of life.</p>

2017 ◽  
Vol 59 (3) ◽  
pp. 13-16
Author(s):  
Kim Outhoff

Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalize pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old.1 By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent acute AOM, and acute otitis media that persists despite antibiotic therapy.2 However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1%–6%).3 This article offers guidance for family practitioners wishing to optimize health outcomes in children potentially requiring tympanostomy tube placement.


2020 ◽  
pp. 115-117
Author(s):  
K Outhoff

Children younger than 7 years are at increased risk of otitis media because of their immature immune systems and poorly functioning eustachian tubes that normally ventilate the middle ear space and equalise pressure with the external environment. More than 80% of children have at least one episode of acute otitis media (AOM) before the age of 3 years and 40% experience six or more recurrences by the time they are 7 years old. By the age of 3 years, approximately 7% of children undergo surgery for tympanostomy tube insertion for a range of otitis media issues, most commonly for chronic otitis media with effusion (OME), recurrent AOM, and acute otitis media that persists despite antibiotic therapy. However, tympanostomy tube insertion is associated with risks and remains a controversial practice especially in children with OME of less than three months’ duration and in children with recurrent AOM. Adverse effects associated with tympanostomy tube insertion include those associated with anaesthesia and its complications (laryngospasm, bronchospasm), as well as tube related sequelae such as recurrent (7%) or persistent (16–26%) otorrhoea, blockage of the tube lumen (7%), granulation tissue (4%), premature extrusion of the tube (4%), tympanostomy tube displacement into the middle ear (0.5%) and persistent perforation of the tympanic membrane (1–6%). This article offers guidance for family practitioners wishing to optimise health outcomes in children potentially requiring tympanostomy tube placement.


2010 ◽  
Vol 125 (3) ◽  
pp. 274-278 ◽  
Author(s):  
I M Vlastos ◽  
M Houlakis ◽  
D Kandiloros ◽  
L Manolopoulos ◽  
E Ferekidis ◽  
...  

AbstractObjective:To determine whether tympanostomy tube insertion has benefit, compared with simple myringotomy, in children with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome caused by adenoid hypertrophy.Methods:Fifty-two children older than three years with obstructive sleep apnoea syndrome were randomly assigned to receive either adenoidectomy plus tympanostomy tube insertion (group one, n = 25) or adenoidectomy plus myringotomy (group two, n = 27). Pre- and post-operative health-related quality of life was assessed using the otitis media-6 (OM-6) tool, and audiological outcomes were recorded six and 12 months post-operatively.Results:Group one showed better quality of life scores six months post-operatively (score difference −0.38, confidence interval −0.65 to −0.10) but not 12 months post-operatively (score difference −0.23, confidence interval −0.76 to 0.11), compared with pre-operative values. Audiological outcomes did not differ significantly at either time point, compared with pre-operative values.Conclusion:Tympanostomy tube insertion confers a short term benefit, compared with simple myringotomy, in children older than three years with otitis media with effusion who receive concurrent adenoidectomy as treatment for obstructive sleep apnoea syndrome. Further studies are necessary to identify which of these children will receive long-lasting benefit from tympanostomy tube insertion.


2005 ◽  
Vol 84 (7) ◽  
pp. 418-424 ◽  
Author(s):  
Stanley Mui ◽  
Barry M. Rasgon ◽  
Raymond L. Hilsinger ◽  
Brent Lewis ◽  
Gretchen Lactao

We measured quality of life issues for both children and their parents on the premise that parental quality of life should be an aspect of cost-effectiveness in otitis media treatment. The patients were less than 18 years of age and had had myringotomy with tube insertion at the head and neck surgery department of a large health maintenance organization. Quality of life for patients, parents, and caregivers was evaluated by telephone survey of parents or caregivers and by retrospective chart review of the number of pre- and postoperative healthcare visits and antibiotic usage. Chart review showed a significant postoperative reduction in the number of clinic visits and in use of antibiotic drugs after insertion of tympanostomy tubes. Improved postoperative hearing was noted, and tympanostomy tube insertion was shown to be safe. The chart-review cost analysis showed that tympanostomy tube insertion is a cost-effective treatment for otitis media in children, and the telephone survey results showed that it improves quality of life for children and their parents or other caregivers.


2020 ◽  
Vol 45 (2) ◽  
pp. 239-247
Author(s):  
Leigh N. Sanyaolu ◽  
Rebecca Cannings‐John ◽  
Christopher C. Butler ◽  
Nick A. Francis

2014 ◽  
Vol 24 (1) ◽  
pp. 4-10
Author(s):  
Melody Harrison

Otitis media with effusion (OME) is described as a collection of fluid in the middle ear, without signs or symptoms of acute ear infection ( Stool, Berg, Berman, & Carney, 1994). The accumulated fluid decreases the ability of both the tympanic membrane (eardrum) and the ossicles in the middle ear to vibrate, resulting in a mild conductive hearing loss. Although 28 decibels (dB) is the average hearing loss associated with OME, the range is quite wide. While some children experience no hearing loss, about 20% have hearing loss of 35 dB or greater ( Gravel, 2003).


2019 ◽  
Vol 133 (4) ◽  
pp. 281-284 ◽  
Author(s):  
H Choi ◽  
D Lee ◽  
Y Hong ◽  
D-K Kim

AbstractObjectiveTo determine the factors related to multiple ventilation tube insertions in children with otitis media with effusion.MethodsA retrospective review was performed of 126 ears of 81 children aged less than 12 years who had undergone insertion of a Paparella type 1 ventilation tube for the first time between August 2012 and March 2018.ResultsMean age at the first operation was 4.0 ± 2.2 years, and the mean duration of otitis media with effusion before the first ventilation tube insertion was 5.4 ± 4.5 months. Among 126 ears, 80 (63.5 per cent) had a single ventilation tube insertion and 46 (36.5 per cent) had multiple insertions. On multivariate logistic regression, tympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion were independent predictive factors of multiple ventilation tube insertions.ConclusionTympanic membrane retraction, serous middle-ear discharge, and early recurrence of otitis media with effusion after the first tube extrusion are associated with multiple ventilation tube insertions.


2020 ◽  
Vol 15 (2) ◽  
pp. 58-61
Author(s):  
Ghassan Hassan Rahim

Background: Otitis media with effusion is characterized by accumulation of fluid in the middle ear in absence of acute inflammation and  it is the most common cause of  acquired hearing loss in children, and may  negatively affect language development failure of medical treatment of middle ear effusion frequently require myringotomy and tympanostomy tube insertion. Objectives: To determine tympanostomy tube complications of tube in children with chronic otitis media with effusion who were treated with Shah Grommet tube insertion. Methods: The Medical records of 162 ears of 87 children (52 male and 35 female) were reviewed respectively, the patients ages were between 3 to 16 years old (mean age =8.11 years), patient were followed for 6-66 months (mean 23.3) after tympanostomy tube insertion. Tube extrusion time was also reviewed in all patients, and the indication for surgery was chronic middle ear effusion. Results: Otorrhea accured in nine ears (5.6%), granulation tissue was seen in 2 ears (1.2%), myringosclerosis in (34.6%) persistent perfor-ation (5.6%), atrophy (23.5%) retraction (16.7%) and medial displacement 1.2% the average extrusion time was 8.5 month ( ± 4.6). Conclusions: complications of tympanostomy tube insertion are common and the most common are otorrhea myringosclerosis, atrophy but they are generally insignificant consequently in majority of these complications there is no need for management.


Author(s):  
Susen Lailach ◽  
Theresa Langanke ◽  
Thomas Zahnert ◽  
Susan Garthus-Niegel ◽  
Marcus Neudert

Abstract Purpose The aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM). Methods This prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index. Results After middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001). Conclusion Preoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.


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