Tympanostomy Tube Insertion Research Articles (Page 1)

Long Term effectiveness of Solo+ TTD: A single step tympanostomy tube (TT) Delivery device.

Tympanostomy tubes are commonly utilized for the treatment of otitis media with effusion (OME), yet the factors influencing treatment efficacy remain elusive. This study investigates the therapeutic outcomes of tympanostomy tube insertion (TTI) in the treatment of OME and identifies the risk factors associated with treatment effectiveness. This retrospective cohort study analyzed patients with OME who underwent successful TTI at the First Affiliated Hospital of Nanjing Medical University between January 2018 and January 2020, with a minimum follow-up period of 1 year. Patient medical records and follow-up data were collected. The study summarized the treatment outcomes across different patient cohorts and identified potential risk factors for OME recurrence. A total of 178 patients with OME who underwent TTI were included in the study, of which 156 were non-tumor patients. These non-tumor patients were categorized into a children’s group (Group A; 47 cases) and an adult group (Group B; 109 cases). Additionally, 22 patients with a history of nasopharyngeal malignant tumors were included as Group C. During the 1-year follow-up, there were 10 relapses in Group A, 51 relapses in Group B, and all patients in Group C relapsed. Among non-tumor patients, the recurrence rate of OME was significantly lower in Group A compared to Group B following TTI. Furthermore, a duration of OME exceeding 1 year was identified as an independent risk factor for disease recurrence. Patients in Group C exhibited a significantly higher proportion of bilateral OME compared to Group B. Following TTI, pediatric patients have a lower recurrence rate of OME compared to adults. Additionally, OME lasting for more than 1 year may represent an independent risk factor for recurrence in non-tumor patients after TTI.

Relationship between timing of tympanostomy tube insertion and mastoid air cell development in children with otitis media.

Comparison of tympanostomy tube insertion with and without radiofrequency ablation eustachian tuboplasty for treating chronic otitis media with effusion.

This retrospective observational study aimed to examine the associations among genetic mutations, demographic characteristics and hearing outcomes in children diagnosed with primary ciliary dyskinesia (PCD). By identifying potential predictors of adverse auditory outcomes, we hope to inform future approaches to clinical care and intervention. A total of 84 children, aged 1-17 years with confirmed PCD, underwent audiological assessments, including age-appropriate audiometry and tympanometry. Hearing loss severity scores (HLSS) were calculated (from 1 (worse hearing) to 4 (better hearing)) using hearing threshold data and analysed alongside tympanometry findings, in relation to age, sex, ethnicity and specific genetic variants, to determine factors influencing hearing outcomes. Children with oligocilia-associated genetic mutations demonstrated significantly worse hearing thresholds (mean HLSS 2.13) compared with the other groups (mean HLSS 3.44) (p<0.001) and had a greater incidence of type B tympanograms (p<0.001). Middle ear effusions were found to improve significantly with increasing age (p<0.001). Male participants showed significantly poorer tympanometry outcomes (p=0.017). Caucasian participants were found to have better hearing thresholds (mean=3.50) versus non-Caucasian children (mean=3.25) (p=0.018). These results highlight key clinical considerations for the management of hearing in paediatric PCD. Routine, early audiological evaluation should be standard practice. Tympanostomy tube insertion should be considered carefully, given that some children exhibit age-related improvement. Male children may warrant more intensive monitoring for middle ear pathology. Genetic profiling may offer prognostic value and support a more individualised approach to management.

Background and Objectives: Otitis media with effusion (OME), frequently associated with obstructive adenoid hypertrophy (OAH), is a leading cause of paediatric hearing loss. Clinically distinguishing effusion types (serous vs. mucoid) and predicting postoperative hearing recovery are unresolved challenges. This study evaluated the utility of preoperative blood inflammatory markers in predicting effusion characteristics and short-term hearing outcomes following adenoidectomy with tympanostomy tube (TT) insertion. Materials and Methods: In this retrospective cohort study, 232 children under 12 years old in 2024 and undergoing adenoidectomy (with or without TT insertion) were categorised into serous OME (n = 42), mucoid OME (n = 78), and non-effusion (n = 112) groups. Preoperative blood sample analyses assessed neutrophil, lymphocyte, eosinophil, basophil, and platelet counts, along with derived indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-basophil ratio (EBR), mean platelet volume (MPV), and systemic immune–inflammation index (SII). Hearing was evaluated at 2 weeks and 1 month postoperatively. Statistical analyses used SPSS v.28, with significance set at p < 0.05. Result: Mucoid OME patients exhibited significantly elevated neutrophil counts, platelet counts, eosinophils, NLR, and SII compared to those in serous OME and non-effusion groups (p < 0.05). All serous OME children achieved normal hearing by the first follow-up, whereas 15.4% of mucoid OME cases had transient mild hearing loss persisting after 2 weeks (p = 0.008; OR=15.97) but resolving by 1 month. Preoperative neutrophil count independently predicted delayed hearing recovery (p = 0.021). Conclusions: Systemic inflammatory markers, particularly neutrophil count, NLR, and SII, effectively differentiate mucoid OME from other effusion types and correlate with short-term hearing recovery. Neutrophil count may serve as a prognostic tool for surgical planning and patient counselling. Prospective studies are warranted to validate these findings in broader paediatric populations.

Trends in paediatric otitis media revealed in national health insurance data in Japan.

Background: Otitis media with effusion (OME) is a common cause of childhood hearing loss. In children, it may co-exist with adenotonsillar enlargement. In such cases, adenotonsillectomy combined with myringotomy and tympanostomy tube insertion is the standard surgical treatment approach worldwide. This study however, investigated whether adenotonsillectomy alone can resolve OME in children with concurrent adenotonsillar disease, with implications for reducing surgical morbidity and healthcare expenditures. Methods: This prospective pre-test-post-test study was conducted at the Department of Otolaryngology, National Hospital Abuja, Nigeria. Ninety-five children (aged 1-8 years) with adenotonsillar hypertrophy and preoperative tympanogram types B or C underwent adenotonsillectomy. Tympanometric evaluations were performed at baseline (2 weeks preoperatively) and 6 weeks postoperatively to assess changes in middle ear function. Results: Pre-operative tympanometry identified OME in 166 ears. Post-operative tympanometry at 6 weeks demonstrated resolution of OME (type B or C to type A tympanogram) in 88 ears (53%, χ2=22.5, p=0.001) which was statistically significant. Among the remaining 78 ears, 41 (24.7%) showed no change, while 37 ears demonstrated changes to alternative tympanogram types, (B to C, C2 to C1, B/C to as), which was considered a partial improvement (resolving OME, but not complete resolution). Conclusions: Findings from this study suggest that adenotonsillectomy alone may resolve otitis media with effusion (OME) in children with coexisting adenotonsillar hypertrophy, with significant improvements observed at a minimum follow-up of 6 weeks.

BackgroundNear-universal pediatric use of pneumococcal conjugate vaccines in the United States (US) has yielded substantive reductions childhood invasive pneumococcal disease (IPD), pneumonia (PNE), and otitis media (OM), especially among at-risk populations. We evaluated residual disparities in disease burden among US children by comorbidity profile and insurance type (as a proxy for socioeconomic status) during the post-PCV13 era.MethodsWe conducted a retrospective observational cohort study using two US healthcare claims databases: Optum Clinformatics DataMart (commercial) and Merative MarketScan Medicaid Multi-State Database. The two study populations comprised children aged <18 years and were stratified by age and comorbidity profile. Study outcomes included IPD, PNE, OM, and tympanostomy tube (TT) insertion, and were ascertained monthly during the follow-up period. Disease rates were expressed per 100,000 person-years, and age-specific relative rates were calculated by insurance type and comorbidity profile.ResultsChildren with comorbidities aged <2 years had the highest rates of IPD and PNE, regardless of insurance status. Rates of IPD and PNE were also higher in children with Medicaid (vs. commercial) insurance; differences generally decreased with increasing age. Differences in incidence of OM and TT insertions between children with (vs. without) comorbidities were absent in the first 2 years of life but became apparent with increasing age.ConclusionChildren with comorbidities and those with Medicaid insurance have a higher burden of IPD, PNE, and OM. Researchers should assess the impact that preventative strategies have on pediatric populations with the highest rates of disease to identify progress in achieving equity in health.

To describe the current tympanostomy tube insertion (TTI) complication rates occurring within 3 years of surgery in the post-intervention era. Current TTI complication rates in children are based on reports from a meta-analysis that was published in 2001, reporting on 16 to 26% otorrhea rates, cholesteatoma development of 0.7%, and tympanic membrane perforation (TMP) of 2.2 to 16%. Since then, interventions aimed at reducing pediatric otitis media burden have been largely implemented worldwide, and indications for TTI have been published. Population-based longitudinal study. Data were anonymously retrieved from a big stable healthcare database between 2005 and 2021. Hospitals and ambulatory surgical centers, nationwide. Children who underwent TTI and completed 3 postoperative follow-up years within the health insurance. We excluded children with previous otological surgery and congenital craniofacial anomalies. Children were categorized into the younger (0-<7 yr) and older (7-18 yr) age groups. TTI (therapeutic). Number of TTI performed per 100,000 children per study year, and cumulative incidence of these postoperative complications: TT removal, otorrhea, TMP, cholesteatoma development, and need for mastoidectomy. Of the 19,920 unique children identified, 86.6% were in the younger age group with a mean age of 3.57 ± 1.59 years, and 61% were boys. At the end of follow-up, older children had statistically significantly higher TMP (6.9% versus 3.3%, p < 0.001), TT removal (5.1% versus 3.8%, p < 0.001), cholesteatoma (2.2% versus 0.8%, p < 0.001), and mastoidectomy (0.8% versus 0.3%, p < 0.001) rates when compared with younger children, respectively. Younger children experienced higher otorrhea rates when compared with older children (11% versus 6.4%, p < 0.001) but for a shorter period (324 ± 290 versus 404 ± 303 days, p < 0.001). Post-TTI complication rates are lower in the post-intervention era, except for cholesteatoma. This current quantitative appreciation of TTI complications can help both patients and caregivers define realistic postoperative expectations.

Objective: This study aimed to compare the impact of surgical treatment (tympanostomy tube insertion) and pharmacological therapy on quality of life (QoL) in patients with chronic secretory otitis media (SOM), focusing on symptom alleviation and functional recovery. Methods: A prospective, longitudinal, non-randomized study was conducted at Chaohu Hospital, China, involving 80 SOM patients (aged 6–60 years) divided into surgical (n=38) and pharmacological (n=42) groups. QoL was assessed using a modified Chinese Chronic Ear Survey (CCES) before and 2–4 months post-treatment. The CCES evaluated activity restriction, symptom severity, and healthcare utilization. Statistical analysis via SPSS 28.0 included paired and unpaired t-tests. Results: Both treatments significantly improved symptom scores (p&lt;0.05), with surgery showing marginally greater efficacy (surgical group symptom score: 24.14→36.21 vs. pharmacotherapy: 26.47→35.15). However, neither intervention demonstrated statistically significant differences in overall QoL improvement (p&gt;0.05). Activity limitation scores remained unchanged post-treatment (surgical: 13.21→13.28; pharmacotherapy: 13.62→14.91), indicating persistent functional challenges. No demographic factors (gender, education, socioeconomic status) influenced outcomes. Conclusion: While both surgical and pharmacological treatments alleviate SOM symptoms, neither fully restores daily functioning, underscoring incomplete QoL recovery. These findings highlight the need for long-term evaluations and personalized treatment strategies. Future research should address study limitations, including small sample size and lack of laboratory-based assessments, to refine therapeutic approaches for holistic patient well-being.

Backround Tympanostomy tube insertion (TTI) is the most common pediatric surgical procedure in otorhinolaryngology. Objectives To evaluate the appropriateness of TTI in relation to national recommendations in Finland. As a secondary aim, we assessed long term ear-related quality of life if surgical criteria are unmet. Materials and methods We retrospectively reviewed all TTI procedures performed on children under 10 years of age in 2019 in Turku University Hospital, Finland. Factors contributing to the operation were identified and evalued in detail. In 2021, caregivers received a questionnaire including Otitis Media 6 -questionnaire to assess ear-related quality of life. Results A total of 355 operations were analyzed. The national criteria for recurrent acute otitis media were met in 119/355 cases (33%) and chronic otitis media with effusion criteria in 81/355 (23%), while 155/355 (44%) did not fulfil either criterion. Ear-related quality of life was high across all groups with no significant differences observed. Conclusions and significance The substantial proportion of procedures conducted outside Finnish recommendations underlines the necessity for continuous professional education and systematic evaluation of clinical decision-making. Observed discrepancies between Finnish and international guidelines further support the re-evaluation of Finnish criteria to ensure alignment with global standards and evidence-based practice.

Some ophthalmic antibiotics are publicly subsidised in New Zealand (NZ) for off-label use in the ear, however, this utilisation has not previously been described. This study compared the utilisation of ophthalmic chloramphenicol and ciprofloxacin in the eye and ear, among NZ children. This study involved clinical record review, and included 11,617 prescriptions of ophthalmic chloramphenicol and ciprofloxacin in 2022, for children aged five years or under in Auckland, NZ. Prescriptions of chloramphenicol and ciprofloxacin for eye and ear use were compared by: patient age, gender, ethnicity and socioeconomic deprivation, indication, community or hospital prescribing and number of repeat prescriptions. Statistical analysis was performed using Chi-squared test and multinomial regression. Most ophthalmic ciprofloxacin was used in the ear (84%). In contrast, almost all chloramphenicol was used in the eye (96%). Post-operative use following tympanostomy tube insertion accounted for half of all hospital-prescribed ophthalmic ciprofloxacin used in the ear. Utilisation of chloramphenicol and ciprofloxacin in the eye and ear was similar, with more prescriptions for children aged one year and males, and most children received only one prescription. Māori and Pacific children generally received fewer prescriptions. Pacific children were more likely than Māori children to receive hospital-prescribed ophthalmic ciprofloxacin for use in the ear (adjusted OR 6.7, p = 0.025). These findings highlight the utilisation of ophthalmic ciprofloxacin in the ear in NZ children. These findings will inform decision-making in the public funding of medications, policy development in equitable medication access, and more collaborative efforts to improve antimicrobial use.

Preventing unnecessary tympanostomy tube placement in children: A 5-year Update.

Otitis media with effusion (OME) is common in children with Down syndrome (DS), affecting 93% of children by age 1 year and 68% of children by age 8 years ( 1,2 ). Resultant conductive hearing loss is present in up to 80% of children with DS and OME, making prompt treatment imperative to prevent adverse effects on language and development ( 2-4 ). Placement of tympanostomy tubes is common treatment for chronic OME with associated conductive hearing loss. However, tympanostomy tube insertion can be challenging in the DS population due to stenotic external auditory canals, a morphologically defining characteristic of DS seen in 40 to 50% of individuals ( 4 ). Adequate visualization is paramount not only for safe tympanostomy tube placement but also to allow for surveillance for retraction pockets, atelectasis, and cholesteatoma. Here, we demonstrate how the use of an endoscope can improve visualization and aid in difficult tube placement in this patient population.

Understanding the distinct subtypes of adhesive otitis media (AdOM) is crucial for appropriate treatment such as balloon Eustachian tuboplasty (BET), particularly in distinguishing between patulous and obstructive Eustachian tube (ET) function. Nevertheless, AdOM caused by patulous Eustachian tube dysfunction (ETD) remains underexplored. This study aims to describe the detailed characteristics and define the patulous type of AdOM associated with patulous ETD (PET). A prospective cohort study. A total of 62 ears of patients diagnosed with AdOM, PET, and traumatic perforation were included from a tertiary referral center (university hospital). Obstructive-AdOM, patulous-AdOM, PET, and a control group with traumatic perforation patients underwent endoscopic examinations, completed symptom questionnaires, and had passive ET opening pressure evaluated using a modified inflation-deflation test following tympanostomy tube insertion. Patulous-AdOM was identified in 43% of the patients and was characterized by significantly lower median opening pressures (222 daPa) than those in patients with obstructive-AdOM (400 daPa) and PET (below 100 daPa). Habitual sniffing was reported in 92.3% of patients with patulous-AdOM, and reduced mastoid pneumatization was observed in both the patulous and obstructive subtypes. Accurate differentiation between patulous-AdOM and obstructive-AdOM is essential because BET may exacerbate symptoms in patients with patulous characteristics. A comprehensive evaluation of ET function is critical before initiating treatment, underscoring the need for tailored approaches to manage AdOM.

Benefits of Adding Adenoidectomy to Tympanostomy Tube Insertion

This study aims to explore the clinical effects of simultaneous balloon eustachian tuboplasty (BET) in treating chronic secretory otitis media (COME) in children with bilateral tonsil and adenoid hypertrophy (TAH), providing a theoretical basis for the clinical application of BET. From January 2023 to January 2024, 30 children diagnosed with COME and bilateral TAH were included in this retrospective study at our hospital. The cohort comprised a total of 55 affected ears. Sixteen patients (28 affected ears) were assigned to the study group, which underwent bilateral ablation of tonsils and adenoids (ATA) combined with tympanostomy tube insertion (TTI) and BET. Fourteen patients (27 affected ears) were assigned to the control group, which received bilateral ATA and TTI only. The observation indicators included otolaryngology specialist examinations, imaging assessments, endoscopic evaluations, hearing examinations, and efficacy assessments. All surgeries were performed successfully without significant complications. Within 48h post-surgery, none of the patients experienced noticeable dizziness, vomiting, earache, or other discomforts. The proportion of symptom improvement in the study group was significantly higher than in the control group (P < 0.001). Additionally, the proportion of tympanogram type A in the study group was significantly greater than that in the control group (P = 0.004). Six months post-operation, the air conduction (AC), bone conduction (BC), and air-bone gap (ABG) values in the study group were significantly lower than those in the control group (all P < 0.05). Furthermore, the effective rate in the study group six months after the operation was significantly higher than that in the control group (P < 0.001). This study confirms the near-term efficacy and safety of the combined approach of ATA, TTI, and BET in treating children with COME. It provides valuable clinical experience and a theoretical foundation for the application of BET in this patient population.

Nasal irrigation (NI) is effective in the treatment of sinonasal disease; however, its efficacy in treating otologic conditions is undetermined. Chronic otorrhea (CO) is an important complication in children with tympanostomy tubes (TT), requiring additional treatment. Determine potential factors of NI that put children with TT at risk of developing CO. Case-control study. Single tertiary level of care pediatric hospital. Consecutive patients under the age of 18 with bilateral TT presenting between June and September 2023 were selected. All patients in this study used NI. The main outcome was the development of CO, defined as 10 or more consecutive days of ear drainage despite proper treatment. Twenty consecutive patients with CO were recruited and compared to 100 consecutive controls without CO. The mean age was similar, with 22.9 ± 18.4 months for the CO group and 25.2 ± 16.4 months for the control group (P = .59). An immediate discharge occurred more frequently in the CO group (80%) than in the control group (46%, P = .005; OR: 4.70; 95% CI: 1.5-13.5). A fast rate of administration of NI was more prevalent in the CO group (75%) compared to the control group (51%, P = .049; OR: 2.88; 95% CI: 1.0-7.6). TT insertion under local anesthesia occurred more frequently in the CO group (45%) than in the control group (22%, P = .03; OR: 2.9; 95% CI: 1.1-7.4). No statistical difference was found between groups in the frequency and volume of NI. No patients with CO used a small volume of NI (≤5 mL). A fast rate of administration of NI was correlated with an increased risk of CO. Patients should be encouraged to apply gentle pressure as it could potentially prevent this complication.

Introduction : Tympanic membrane perforation is mostly due to infection, trauma or post tympanostomy tube insertion. A variety of autografts have been used for closure of tympanic membrane perforation such as perichondrium. temporalis fascia, cartilage fat, platelet rich plasma, and chemical cauterization. Material and Method : A Prospective, Comparative and Randomized study . Eighty Patients visiting E.N.T Outpatient department at tertiary care center were selected fulfilling the inclusion criteria and exclusion criteria. Results : Out of 43 patients in fat graft myringoplasty, the surgery was successful in 39 (90.70%) patients. However, the success rate in chemical cauterization was found to be 88% (in 37 out of 42 patients). Overall success rate is 89.40% (in 76 out of 85). Conclusion : Fat graft myringoplasty and chemical cauterization are strongly recommended for closure of small tympanic membrane perforations; however multiple sittings are required for chemical cauterization