scholarly journals Simulation Platform for Myringotomy with Ventilation Tube Insertion in Adult Ears

2018 ◽  
Vol 33 (2) ◽  
pp. 14-20
Author(s):  
Abner L. Chan ◽  
Ryner Jose D. Carrillo ◽  
Kimberly C. Ong
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Expert Panel ◽  
Otitis Media With Effusion ◽  
University Hospital ◽  
Average Score ◽  
Simulation Platform ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Common Error

Objective: To develop a ventilation tube insertion simulator for training and evaluation of otorhinolaryngology residents in myringotomy with ventilating tube insertion. Methods:             Design:            Cross - Sectional Study             Setting:           Tertiary National University Hospital             Participants:   Otologists and otorhinolaryngology resident trainees A simulation tool for myringotomy with ventilation tube insertion was fabricated using silicone sealant, aluminum tube, rubber ball, plaster of paris and plastic sheet, and pretested by our expert panel. Residents were then evaluated using an objective structured clinical examination (OSCE) checklist while performing the procedure using the same model. Three trials were given, and OSCE scores were obtained, for each resident. Result: The pinna, ear canal, tympanic membrane, malleus handle were deemed realistic by the expert panel. Residents performed the procedure at an average of 87 seconds. Average OSCE score for all residents was 17.17, with senior residents having a higher average score (18.3) than junior residents (16.6). However, this was not statistically significant (2 tailed t-value, significance level 0.05 = -1.27, p = .227). The most common cause of trial failure was dropping of the tube in the middle ear, while the most common error made was using more than 2 attempts at performing the incision. Conclusion:  This simulation platform may be a valuable tool to use in educating and developing skills and proper technique of myringotomy with ventilation tube insertion. It is reproducible, affordable, realistic, sturdy and versatile in its applications. Residents who show adequate dexterity and consistency during simulation may eventually be allowed to perform the procedure on patients and provide feedback regarding the usefulness of the simulation. Keywords: otitis media with effusion, middle ear ventilation, tympanic membrane, models, educational, simulation training, patient simulation

scholarly journals Middle Ear Ventilation Tube in Patients with Cleft Palate at King Abdulaziz University Hospital

2017 ◽  
Vol 24 (2) ◽  
pp. 290-2
Author(s):  
Talal A. AlKhatib ◽  
Yasir S. Jamal ◽  
Abdulaziz H. Alghamdi ◽  
Bhaa M. Simbawa ◽  
Yahya H. Ghunaim ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Medical Records ◽  
Otitis Media With Effusion ◽  
University Hospital ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Middle Ear Ventilation ◽  
King Abdulaziz University

This study aims to determine the number of patients with cleft palate requiring treatment for otitis media with effusion. Speech and hearing assessments were also considered. We conducted a retrospective study from January, 2005 through December, 2012 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, on otitis media with effusion in patients with cleft palate. We reviewed patients’ medical records to determine the number requiring treatment for otitis media with effusion, the timing of middle ear ventilation tube insertion, the number of tubes to be inserted, and the type of tube to be used. Data were collected from the patients’ medical records. Ethical approval was obtained by the university’s ethical committee. A total of 101 patients were diagnosed with cleft palate spectrum. Among them, we found that only 12 patients had a hearing assessment and tympanograms performed followed by middle ear ventilation tube insertion. This may indicate the need for more involvement of the otolaryngologists in the multidisciplinary clinical teams for evaluating cleft palate patients.

Analysis of factors associated with multiple ventilation tube insertions in children with otitis media with effusion

2019 ◽  
Vol 133 (4) ◽  
pp. 281-284 ◽  
Author(s):  
H Choi ◽  
D Lee ◽  
Y Hong ◽  
D-K Kim
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Early Recurrence ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Tube Extrusion ◽  
First Time ◽  
Tympanic Membrane Retraction

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.

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.

EVALUATING THE RESULTS OF TREATMENT FOR OTITIS MEDIA WITH EFFUSION BY VENTILATION TUBE INSERTION

2016 ◽  
pp. 81-86
Author(s):  
Phuoc Minh Hoang ◽  
Thanh Thai Le
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Clinical Intervention ◽  
Normal Function ◽  
Common Disease ◽  
Age Group ◽  
Ventilation Tube ◽  
Tube Insertion

Background: Otitis media with effusion (OME) is a common disease especially in children. Objective: To study clinical, tympanometry, audiometry and the results of ventilation tube insertion. Materials and methods: Prospective study with clinical intervention in 114 ears of 76 patients with OME. Results: The most common age group was ≤ 6 years of age (39.5%). Common symptoms in ≤6 years of age group are nasal obstruction (73.3%), rhinorrhea (66.7%); in > 6 years of age group are tinnitus (78.3%), hearing loss (76.1%). Tympanic membrane findings: completed opaque (40.4%), air-fluid level (64.1%), retraction (44.7%), losing cone of light (87.7%). Tympanograme type B was 78.1%. Audiograme was conductive hearing loss with PTA > 20 db (100%). Ventilation tube insertion one or both side associated with or without adenoidectomy. After 6 months of follow-up, postoperative average PTA was 28.4±1.6 dB. Most of cases have dry ear, hearing improvement, tubes on the tympanic membrane. Common complications were otorrhea and extrusion. Conclusion: OME is asymptomatic especially in children. Tympanograme plays a key role in diagnosis. Ventilation tube insertion improves the hearing and restores the normal function of the middle ear.

Myringotomy and ventilation tube insertion: a ten-year follow-up

1997 ◽  
Vol 111 (3) ◽  
pp. 257-261 ◽  
Author(s):  
D. N. Riley ◽  
S. Herberger ◽  
G. McBride ◽  
K. Law
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Recurrent Infection ◽  
Tympanic Membrane Perforation ◽  
Significant Loss ◽  
Type I ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Ventilation Tubes

AbstractEighty children who had myringotomy performed for otitis media with effusion in 1984 were reviewed in 1994. This had involved surgery on 158 ears. Three aspects of ear condition were studied: hearing loss, tympanic membrane perforation, and tympanosclerosis. Hearing losses were present in 13 ears (8.2 per cent), involving 10 children (12.5 per cent), although losses were under 20 dB in seven of these ears (five patients).Of the six ears with losses more than 20 dB (3.8 per cent), in five patients bilateral losses of 30 dB were due to a recurrence of effusions, a large dry posterior perforation was the cause of a 30 dB loss, an infected anterior perforation had caused a 30 dB loss, an ear which had a cholesteatoma, and had a mastoidectomy and ossiculoplasty in 1987, had a 30–40 dB loss, and one ear which had a Type I tympanoplasty in 1994 had a 50 dB loss. Therefore in only three ears (1.9 per cent) could hearing loss be associated directly with myringotomy and ventilation tube insertion.Perforations had persisted unilaterally in seven patients, three having had tympanoplasties. Of the remaining perforated tympanic membranes, two were free of symptoms, one had only a slight hearing loss, and one had a more significant loss with recurrent infection.Tympanosclerosis was only found in those ears which had ventilation tubes inserted (and not those which had myringotomy only), occurring in 48 ears (31 per cent, or 39 per cent of those which had a ventilation tube inserted).There was no link between tympanosclerosis and hearing loss. The site of tympanosclerosis was not restricted to the site of myringotomy, and in many cases was present only in other areas of the tympanic membrane. There was a tendency for more extensive tympanosclerosis to occur in those ears which had more ventilation tube insertions. The risk of perforation in particular lends support to a policy of ‘watchful waiting’.

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

2020 ◽  
Vol 6 (3) ◽  
pp. 538
Author(s):  
Ashutosh S. Kumar ◽  
Gundappa D. Mahajan ◽  
James Thomas ◽  
Tejal A. Sonar
Keyword(s):  
Quality Of Life ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Age Groups ◽  
Tympanostomy Tube ◽  
Tube Insertion ◽  
Increased Risk

<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>

scholarly journals Long-term Outcome of the Management of Otitis Media with Effusion in Children with and Without Cleft Palate Using the House-brand Polyethylene Ventilation Tube Insertion

2021 ◽  
Vol 73 ◽  
pp. 245-251
Author(s):  
Kitirat Ungkanont ◽  
Alisa Tabthong ◽  
Chulaluk Komoltri ◽  
Amornrut Leelaporn ◽  
Vannipa Vathanophas ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Hearing Outcome

Objective: To study the long-term outcome of otitis media with effusion in children with and without cleft palate treated with the same protocol of ventilation tube insertion. Materials and Methods: A retrospective cohort study was conducted in eighty-five children with cleft palate and 80 children without cleft palate who had otitis media with effusion and had follow-up between 2001 and 2019. Both groups were treated with ventilation tube insertion for longstanding middle ear effusion more than 90 days. The main outcome was the cumulative incidence of surgical management, time of the indwelling ventilation tubes, conditions of the tympanic membrane, and the hearing outcome. Results: At 24 months old, 63.5% of children with cleft palate and 11.3% of children without cleft palate had their first ventilation tube insertion. Repeated surgery was done in 81.2% of children with cleft palate and 50% of children without cleft palate (p < 0.001). The median duration of the indwelling tube was 11.3 months in the children with cleft palate and 12.4 months in the non-cleft children (p = 0.82). At the end of the study, 63.7% of children without cleft palate and 43.5% of children with cleft palate had normal tympanic membrane (p = 0.009). The hearing outcomes of children with and without cleft palate were 20.7 dB and 19.3 dB, respectively. Conclusion: Children with and without cleft palate were managed under the same guideline and the hearing outcome was favorable in both groups.

Adenoid mast cells and their role in the pathogenesis of otitis media with effusion

2006 ◽  
Vol 120 (7) ◽  
pp. 556-560 ◽  
Author(s):  
B Abdullah ◽  
S Hassan ◽  
D Sidek ◽  
H Jaafar
Keyword(s):  
Mast Cells ◽  
Light Microscopy ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Computer Software ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Cross Sectional

Introduction: Otitis media with effusion (OME) is an inflammation of the middle ear in which a collection of liquid is present in the middle-ear space while the tympanic membrane is intact. The association between adenoid inflammation and OME has long been noted but the exact mechanism is still much debated. We studied the role of adenoid mast cells in the causation of OME.Objective: To study the distribution and role of adenoid mast cells in the causation of OMEMethodology: A cross-sectional, prospective study was carried out in the otorhinolaryngologic clinic, department of otorhinolaryngology (ORL), Science University of Malaysia, from June 1999 to September 2001. A total number of 50 cases were studied. Twenty-five of these patients underwent adenoidectomy, while another 25 patients underwent adenoidectomy and myringotomy with ventilation tube insertion. The adenoid specimens from all patients were examined for the number of adenoid mast cells present, using light microscopy and toluidine blue as the staining agent. The results were analysed using SPSS version 10.0 computer software.Result: The population of adenoid mast cells in children with OME was significantly greater than that in children without OME (p = 0.000).Conclusion: The increased number of adenoid mast cells in patients with OME suggests that inflammation may play a role in this condition.

scholarly journals Postoperative results of ventilation tube insertion: a retrospective multicenter study for suggestion of grading system of otitis media with effusion

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan Il Song ◽  
Byung Chul Kang ◽  
Chol Ho Shin ◽  
Yun Suk An ◽  
Tae Su Kim ◽  
...  
Keyword(s):  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Grading System ◽  
Air Bubbles ◽  
Tympanic Cavity ◽  
Ventilation Tube ◽  
Middle Ear Effusion ◽  
Tube Insertion ◽  
Postoperative Results ◽  
Ear Effusion

Abstract Background In otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate. This study aimed to visualize and classify the clinical manifestations of OME and the correlation between the new grading system and postoperative results after ventilation tube insertion (VTI). Methods We classified the collective 1,012 ears from 506 patients into six groups: grade 0 (no effusion), grade I (scant effusion, but abnormal), grade II (effusion less than half of the tympanic cavity), grade III (effusion over half of the tympanic cavity, with air bubbles), grade IV (complete effusion), and grade V (retracted tympanic membrane or hemotympanum without air bubbles). Results The mean age at VTI was 5.2 (±2.9) years and mean duration between diagnosis and operation was 4.1 (±1.8) months. Between the grades, the nature of the middle ear effusion was also significantly different (p < 0.001). The duration of ventilation tube retention after VTI was significantly different when compared between two groups: grade I-IV and grade V (p = 0.019). Our results showed that the recurrence rate, as well as rate of revision VTI, increased as the grade increased (p < 0.001). Conclusions The new grading system of OME using endoscopic otoscope evaluation had a significant correlation with the age at VTI, the nature of middle ear effusion, the recurrence rate of OME, and the rate of revision VTI.

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