The Relation between Tympanostomy Tube Otorrhea and Types of Immune Cells in Middle Ear Effusion in Children with Otitis Media with Effusion

ABSTRACT Tympanostomy tube (TT) insertion for ventilation of the middle ear is one of most commonly performed procedures in the United States. Indications for tube insertion include otitis media with effusion, recurrent acute otitis media, hearing loss caused by middle ear effusion and persistent acute otitis media. In general, TTs are divided into two categories, short-term tubes and long-term tubes. Depending on the indications for tube placement and surgeon experience with the TT, different tubes can be used. A myriad of tubes have been created since their first documented use in 1845 in attempts to provide better middle ear ventilation, improve ease of placement and prevent complications, such as post-tube otorrhea, persistent perforation and tube occlusion. In order for a tube to be effective, it should be biocompatible with the middle ear to minimize a foreign body reaction. Teflon and silicone remain two of the most commonly used materials in TTs. In addition, the tube design also plays a role for insertion and retention times of TTs. Lastly, TTs can also be coated with various substances, such as silver-oxide, phosphorylcholine and more recently, antibiotics and albumin, in order to prevent biofilm formation and decrease the rate of post-TT otorrhea. Persistent middle ear effusion affects many children each year and can impact their quality of life as well as hearing and language development. With nearly 1 out of every 15 children by the age of 3 years receiving TTs, it is imperative that the right tube be chosen to facilitate optimal ventilation of the middle ear while minimizing complications. How to cite this article Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

Download Full-text

Tympanostomy Tube Complication in Otitis Media with Effusion

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v15i2.163 ◽

2020 ◽

Vol 15 (2) ◽

pp. 58-61

Author(s):

Ghassan Hassan Rahim

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Tympanostomy Tube ◽

Middle Ear Effusion ◽

Tube Insertion ◽

Patients Âgés ◽

Acquired Hearing Loss ◽

Ear Effusion

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.

Download Full-text

To Tube or Not to Tube: That Continues to Be the Question

PEDIATRICS ◽

10.1542/peds.76.2.332a ◽

1985 ◽

Vol 76 (2) ◽

pp. 332-332

Author(s):

DAVID W. TEELE ◽

BERNARD ROSNER ◽

JEROME O. KLEIN

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Speech And Language ◽

Clinically Significant ◽

Ear Effusion

In Reply.— We appreciate Chamberlin's thoughtful comments about the associations between otitis media with effusion and development of speech and language and his concern about results that are statistically significant but may not be "clinically significant." We share his view that measurements of the sequelae of disease should include those that are meaningful to the child. We reported results of tests of speech and language that indicated that children who had spent many days with middle ear effusion during the first years of life scored significantly lower than did children who had not spent such time.

Download Full-text

Efficacy of medical treatment as an adjunct to surgery in the treatment of secretory otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100101124 ◽

1986 ◽

Vol 100 (12) ◽

pp. 1347-1350 ◽

Cited By ~ 8

Author(s):

T. H. J. Lesser ◽

M. I. Clayton ◽

D. Skinner

Keyword(s):

Medical Treatment ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Randomised Trial ◽

Control Group ◽

Middle Ear Effusion ◽

Secretory Otitis Media ◽

Ear Effusion

AbstractIn a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant—antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle-ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p=0.06).

Download Full-text

Experimental Otitis Media With Effusion Induced by Middle Ear Effusion

The Laryngoscope ◽

10.1288/00005537-199209000-00014 ◽

1992 ◽

Vol 102 (9) ◽

pp. 1037???1042 ◽

Cited By ~ 9

Author(s):

Junko Nakata ◽

Masashi Suzuki ◽

Hideyuki Kawauchi ◽

Goro Mogi

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Ear Effusion

Download Full-text

Experimental Otitis Media with Effusion following Middle Ear Inoculation of Nonviable H Influenzae

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948409300113 ◽

1984 ◽

Vol 93 (1) ◽

pp. 52-56 ◽

Cited By ~ 83

Author(s):

Thomas F. DeMaria ◽

David J. Lim ◽

Bruce R. Briggs ◽

Nobuhiro Okazaki

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Animal Experiment ◽

Otitis Media With Effusion ◽

Type B ◽

Negative Bacterium ◽

Middle Ear Effusion ◽

Sterile Saline ◽

Inflammatory Changes ◽

Ear Effusion

In order to test the hypothesis that nonviable bacteria can induce middle ear inflammation leading to persistent middle ear effusion (MEE), we conducted an animal experiment using formalin-killed Hemophilus influenzae, the bacterium reported to be the most common pathogen isolated from chronic MEEs. Over 70% of the chinchillas injected with formalin-killed H influenzae type b or a nontypeable isolate developed sterile, straw-colored serous MEEs, and exhibited histological evidence of extensive inflammatory changes of the middle ear mucosal connective tissue and epithelium. Control animals injected with pyrogen-free sterile saline did not exhibit any inflammatory changes or effusions in the middle ears. Our data suggest that endotoxin on the surface of H influenzae, a gram-negative bacterium, may be responsible for the induction of the otitis media with effusion. It is suggested that endotoxin (even when the organisms are no longer viable) may be responsible for the production of serous MEE and inflammatory changes in the middle ear.

Download Full-text

Otitis Media, Cleft Palate, and Middle Ear Ventilation

Otolaryngology ◽

10.1177/019459988108900228 ◽

1981 ◽

Vol 89 (2) ◽

pp. 288-293 ◽

Cited By ~ 11

Author(s):

William L. Meyerhoff ◽

Donald A. Shea ◽

Craig A. Foster

Keyword(s):

Cleft Palate ◽

Otitis Media ◽

Middle Ear ◽

Tympanostomy Tube ◽

Middle Ear Effusion ◽

Tympanostomy Tubes ◽

Middle Ear Ventilation ◽

Ear Effusion

Chinchillas with unilateral tympanostomy tubes in place underwent palate-clefting in an effort to determine the histologic and bacteriologic effects of using tympanostomy tubes in the treatment of otitis media. The tympanostomy tube appeared to almost totally eliminate the occurrence of middle ear effusion but had much less, if any, effect on eliminating the middle ear inflammation which occurs in the clefted chinchilla.

Download Full-text

IL-5 and Eotaxin Levels in Middle Ear Effusion and Blood from Asthmatics with Otitis Media with Effusion

Acta Oto-Laryngologica ◽

10.1080/0036554021000028117 ◽

2003 ◽

Vol 123 (3) ◽

pp. 383-387 ◽

Cited By ~ 35

Author(s):

Manabu Nonaka ◽

...

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Middle Ear Effusion ◽

Ear Effusion

Download Full-text

The Role of Coagulase-Negative Staphylococci in Chronic Otitis Media With Effusion

Otolaryngology ◽

10.1177/019459988209000628 ◽

1982 ◽

Vol 90 (6) ◽

pp. 837-843 ◽

Cited By ~ 10

Author(s):

Joel M. Bernstein ◽

Diane Dryja ◽

Erwin Neter

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Chronic Otitis Media ◽

Antibiotic Sensitivity ◽

Middle Ear Effusion ◽

Coagulase Negative Staphylococci ◽

Heterogenous Group ◽

Ear Effusion

Twenty-eight middle ear effusions from 27 patients with chronic otitis media with effusion were studied for the presence of bacteria. The most common isolates were coagulase-negative staphylococci. However, biochemical and antibiotic sensitivity patterns demonstrated that these organisms represented a heterogenous group. At least three subtypes of coagulase-negative staphylococci were identified from the middle ear effusions, and in only one instance was the isolate from the ear canal identical with that of the middle ear effusion. The data presented suggest that coagulase-negative staphylococci from the middle ear effusions may not be contaminants; however, it cannot be determined from this study whether these organisms play a role as pathogens or as the result of indolent colonization.

Download Full-text