scholarly journals Self-Retaining Harpoon Tympanostomy Tube with Applicator

2007 ◽  
Vol 22 (1-2) ◽  
pp. 27-30
Author(s):  
Konrad P. Aguila

Objective: To describe a novel harpoon design for a low cost, self retaining tympanostomy tube with applicator used in a 38-year-old female for otitis media with effusion. Methods:    Study design: Instrumental Innovation/Case Report Setting:  Tertiary Hospital in Metro Manila Results:   The tympanostomy tube was inserted under endoscopic guidance within 10 seconds, remained in place for two months with relief of symptoms, and spontaneously extruded by the seventh month of follow-up. Conclusion:  The harpoon-designed tube with applicator provided ease of insertion and good anchorage in the tympanic membrane.  Maximizing the use of a stylet-needle as both perforator and applicator simplified the tympanostomy and ventilating tube insertion procedures into a single maneuver.     Key words: middle ear ventilation, tympanostomy tube insertion, grommet  insertion, instrumentation

2021 ◽  
pp. 014556132110257
Author(s):  
Joel W. Jones ◽  
Daniel P. Ballard ◽  
Todd A. Hillman ◽  
Douglas A. Chen

Objectives: To evaluate the effectiveness of mastoidectomy with antibiotic catheter irrigation in patients with chronic tympanostomy tube otorrhea. Methods: A chart review of adult and pediatric patients with persistent tympanostomy tube otorrhea who had failed outpatient medical management and underwent mastoidectomy with placement of a temporary indwelling catheter for antibiotic instillation was performed. Patients were retrospectively followed for recurrent drainage after 2 months and outcomes were categorized as resolution (0-1 episodes of otorrhea or otitis media with effusion during follow-up), improvement (2-3 episodes), or continued episodic (>3 episodes). Results: There were 22 patients and 23 operated ears. Median age was 46 years (interquartile range, IQR = 29-65). The median duration of otorrhea from referral was 5.5 months (IQR = 2.8-12). Following surgery, 14 ears had resolution of drainage, 6 had improvement, and 3 had episodic. The observed percentage of resolved/improved ears (87%) was significant ( P = .0005, 95% CI = 67.9%-95.5%). Median follow-up time was 25 months (IQR = 12-59). Pre and postoperative pure tone averages improved (difference of medians = −3.3 dB, P = .02) with no significant difference in word recognition scores ( P = .68). Methicillin-resistant Staphylococcus aureus was the most common isolated microbe while no growth was most frequently noted on intraoperative cultures. Conclusions: Mastoidectomy with antibiotic catheter irrigation may be an effective surgical strategy, and single stage alternative to intravenous antibiotics, for select patients with persistent tube otorrhea who have failed topical and oral antibiotics.


RSBO ◽  
2018 ◽  
Vol 1 (3) ◽  
pp. 186
Author(s):  
Katiane Vieira Menezes Leite ◽  
Patrícia Oliveira de Souza ◽  
Jussania Fonseca da Paz ◽  
Ana Beatriz Franco Fernandes ◽  
Leonardo Fernandes da Cunha ◽  
...  

Introduction: The gingival melanin hyperpigmentation (GMH) is resulted from an abnormal deposition of melanin, but it is not a pathology. However, GMH is an esthetic problem for some people. Some alternatives of treatment for this situation exist. The epithelial abrasion has been an interesting alternative because it has a satisfactory esthetic outcome, is a fast procedure, of easy execution, and low cost. Recently, tips adapted in ultrasound (CVDentus) can bean alternative approach. Objective: To report a clinical case of GMH treated by the technique of the epithelial abrasion with association of instrument adapted in ultrasound. Case report: Patient aged 28 years, melanoderm, sought treatment due to esthetic dissatisfaction because of intense dark color in the maxillary gingiva. The GMH removal was proposed through the technique of the epithelialabrasion CVD bur. Conclusion: The technique of epithelial abrasion using CVD bur was effective in removing GMH at one-year follow-up showing to be easy and safe technique.


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 71 (4) ◽  
pp. 415-420 ◽  
Author(s):  
Maria Beatriz Rotta Pereira ◽  
Denise Rotta Ruttkay Pereira ◽  
Sady Selaimen da Costa

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 20-23 ◽  
Author(s):  
G. Scott Giebink

Recurrent acute otitis media (AOM) is an extremely prevalent disease in young children. Epidemiologic associations suggest that primary prevention or reduction of AOM frequency may be achieved with breast-feeding during infancy, elimination of household tobacco smoking, and use of small rather than large day-care arrangements for infants and toddlers. Secondary antimicrobial prophylaxis with amoxicillin or sulfisoxazole reduces the frequency of recurrent AOM by about 50%, but it does not appear to reduce the duration of otitis media with effusion (OME). Tympanostomy tube insertion is not as effective as amoxicillin in reducing AOM frequency in children without OME. Adenoidectomy appears to be warranted for children who develop recurrent AOM after extrusion of tubes. Vaccines against the common bacteria and viruses causing AOM hold the greatest promise of preventing AOM and blocking the sequence of pathologic events leading to chronic OME and middle ear sequelae. The greatest progress has been made recently with pneumococcal protein conjugate vaccines, and clinical testing is in progress.


2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Mahmoud F. Rateb ◽  
Hazem Abdel Motaal ◽  
Mohamed Shehata ◽  
Mohamed Anwar ◽  
Dalia Tohamy ◽  
...  

Purpose. To compare safety and efficacy between a low-cost glaucoma drainage device (GDD), the Aurolab aqueous drainage implant (AADI), and the Baerveldt glaucoma implant (BGI) in refractory childhood glaucoma in Egypt. Methods. This is a retrospective study of patients who received either an AADI or BGI at a tertiary care postgraduate teaching institute. Children aged <16 years with uncontrolled intraocular pressure (IOP) with or without prior failed trabeculectomy who completed a minimum 6-month follow-up were included. The outcome measures were IOP reduction from preoperative values and postoperative complications. Results. Charts of 57 children (younger than 16 years old) diagnosed with refractory childhood glaucoma were included. Of these, 27 eyes received AADI implants (group A), while 30 received BGI implants (group B). The mean preoperative baseline IOP was 34 ± 5 mmHg in group A versus 29 ± 2 mmHg in group B (p=0.78) in patients on maximum allowed glaucoma medications. In group A versus group B, the mean IOP decreased to 13.25 ± 8.74 mmHg (p=0.6), 12.8 ± 5.4 mmHg (p=0.7), and 12.6 ± 5.6 mmHg (p=0.9) after 1 week, 3 months, and 6 months, respectively. However, in group A, an anterior chamber reaction appeared around the tube in 14 cases starting from the first month and resolved with treatment in only 4 cases. In the other 10 cases, the reaction became more severe and required surgical intervention. This complication was not observed in any eye in group B. Conclusion. AADI, a low-cost glaucoma implant, is effective in lowering IOP in patients with recalcitrant paediatric glaucoma. However, an intense inflammatory reaction with serious consequences developed in some of our patients; we believe these events are related to the valve material. We therefore strongly recommend against its use in children.


2007 ◽  
Vol 122 (6) ◽  
pp. 580-583 ◽  
Author(s):  
P M Spielmann ◽  
H McKee ◽  
R M Adamson ◽  
G Thiel ◽  
D Schenk ◽  
...  

AbstractIntroduction:There is a paucity of evidence to guide the post-operative follow up of patients undergoing middle-ear ventilation tube insertion for the first time. This study was conceived to identify current practice at our institution (Ninewells Hospital, Dundee) and to inform subsequent change in our follow-up procedure.Methods:Two cycles of data collection and analysis were performed. All paediatric patients undergoing ventilation tube insertion for the first time were identified. Patients who had previously undergone ventilation tube insertion or additional procedures such as adenoidectomy or tonsillectomy were excluded. The first data collection period comprised all of the year 2000, and the second 18 months over 2003–2004. A minimum of 20 months' follow up was allowed for. Data regarding clinical findings and audiometry were recorded at each follow-up appointment.Results:We identified a total of 50 patients meeting our criteria for inclusion in the first cohort. There were a total of 156 appointments between surgery and data collection (a mean of 3.12 per child). A total of 113 (72 per cent) appointments lead to no medical intervention. The only statistically significant difference between patients requiring further ventilation tube insertion (n = 10) and those not requiring further treatment during the study period (n = 40) was the average hearing threshold (p < 0.01). These findings prompted a change in the post-operative regime; all patients undergoing ventilation tube insertion were subsequently seen at three months for a pure tone audiogram, and further review depended on clinical and audiometric findings. Records for 84 children were identified and collected for the second cohort, there were a total of 154 appointments (a mean of 1.83 per child). In only 18 appointments (12 per cent) were normal findings and hearing recorded and children given a further review appointment. Sixteen of 29 (55 per cent) children with abnormal clinical findings (otorrhoea, tube blockage or extrusion) required some form of intervention (p < 0.05). Twenty-six had a mean hearing threshold worse than 20 dB at first review. Nineteen (73 per cent) required further intervention of some sort (p < 0.01).Conclusions:Our study demonstrated that the vast majority of review appointments resulted in no clinical intervention. We therefore question the need for regular follow up in this patient group. Twenty per cent (10 of 50 and 18 of 84) of our patients required further ventilation tube insertion within the study periods. This is consistent with rates reported in the literature. Children with abnormal clinical findings or a mean hearing threshold greater than 20 dB were significantly more likely to require further intervention. We would recommend one post-operative review with audiometry, three months after surgery. At this initial appointment, further review should be offered to those children with poor hearing, early extrusion, blockage or infection, as they are more likely to require further ventilation tube insertion. This strategy is dependent on good links with community primary care providers and easy access to secondary care for further management, should this be required.


2012 ◽  
Vol 127 (3) ◽  
pp. 321-322 ◽  
Author(s):  
T A van Essen ◽  
J B van Rijswijk

AbstractObjective:This paper describes a patient with recurrent unilateral nasal discomfort and pain due to an intranasal tooth. A short overview of the literature is provided in relation to the aetiology, symptomatology, diagnosis and treatment of intranasal teeth.Case report:A 26-year-old man was referred with a history of recurrent left-sided nasal obstruction, facial pain and discomfort, and chronic purulent rhinorrhoea. Computed tomography revealed a nasal tooth, which was likely to have been the cause of these symptoms. After transnasal surgical extraction under endoscopic guidance, the patient was relieved of his complaints (at the one-year follow up).Conclusion:An ectopic tooth in the nasal cavity is a rare phenomenon, and in most cases the cause of an intranasal tooth remains unclear. The treatment of an intranasal tooth entails surgical extraction even though such teeth may remain asymptomatic; several cases have illustrated the potential significant morbidity associated with their occurrence.


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