Myringotomy Research Articles

Does Physician Ownership of Ambulatory Surgical Centers Influence Use of Tympanostomy Tubes

Significant variation exists in the surgical practice of placing tympanostomy tubes for chronic otitis media in children. In a database review,

Do demographic disparities exist in the diagnosis and surgical management of otitis media?

Determine if demographic disparities exist between the diagnosis of otitis media (OM) and the provision of myringotomy and tubes in children. Cross-sectional analysis of a national database. The National Ambulatory Medical Care Survey 2010 and the National Hospital Ambulatory Medical Care Survey-Ambulatory Surgery 2010 were abstracted for cases with a diagnosis of OM and myringotomy and tube (MT) procedures in children, respectively. Sex, race, ethnic, and insurance distributions were computed for OM and MT and then compared for healthcare disparities between rates of OM diagnoses and MT procedures. A total of 13.6 million ambulatory pediatric OM diagnoses were identified in 2010 (55.9% male; 82.4% white, 11.3% black, and 6.3% other; 14.3% Hispanic, 85.7% non-Hispanic). A total of 413 thousand ambulatory myringotomy procedures were identified (59.6% male; 86.0% white, 11.0% black, and 3.0% other; 13.0% Hispanic, 87.0% non-Hispanic). There was no statistically significant difference in the provision of MT versus OM diagnosis according to sex (P = 0.400), race (P = 0.313), or ethnicity (P = 0.228). There was also no statistically significant difference in the percentage of Medicaid coverage for OM children (37.0%) versus those undergoing MT (31.1%; P = 0.376). There does, however, appear to be a statistically higher percentage of non-Hispanic children being diagnosed with otitis media than Hispanic children (P = 0.049). There were no significant demographic differences in the incidence of children with OM undergoing MT with respect to sex, race, ethnicity, or insurance status. As a specialty, otolaryngology does not appear to exhibit any disparate healthcare access bias in providing MT to children with OM. NA Laryngoscope, 128:2898-2901, 2018.

Myocardial Infarction in an Infant with Complete Recovery of Function

Introduction: Myocardial infarction (MI) in infants without congenital abnormality of the coronary arteries is a rare entity with high mortality. We describe our experience managing such a patient. Case: The patient was born at 32/6 weeks’ gestation with cleft lip and palate. While in the NICU, a murmur was noted and echocardiography revealed a PFO and PDA. Coronary arteries appeared to have normal origin and flow. He was discharged home at 2 months of life and remained asymptomatic. At 4 months of age he underwent myringotomy tube placement and cleft lip repair with general anesthesia. …

Cost Effectiveness of Treatments for Acute Tympanostomy Tube Otorrhea

Up to 60% of children with tympanostomy tubes develop otorrhea secondary to middle ear infection. In a prior Dutch study, researchers showed that

Efficacy of adenoidectomy combined myringotomy in treatment of children with secretory otitis media

Objective To evaluate the efficacy of combination of myringotomy adenoidectomy in treatment of children with secretory otitis media.Methods 36 children patients with secretory otitis media from March 2010 to February 2013 in our hospital were randomly divided into two groups,a control group of 18 patients taking endoscopic tympanostomy tube treatment; 18 cases in observation group took endoscopic tympanostomy tube joint adenoidectomy treatment,the incidence of the two groups were observed as well as the efficacy and complications.Results The total effective rate in observation group was 94.4％,while 83.2％ in the control group,showing statistical significant difference (P ＜ 0.05).Complications occurred in the observation group was 16.7％; while it was 36.1％ in the control group,showing statistical significant difference (P ＜ 0.05).Conclusion The combination of myringotomy and adenoidectomy has good clinical efficacy in the treatment of secretory otitis media,which is good for children,with high safety factor,deserved to be promoted in clinical practice. Key words: Adenoidectomy; Myringotomy; Secretory otitis media; Efficacy

School performance and behaviour change after adenoidectomy with myringotomy in children suffering from otitis media with effusion

DOI: http://dx.doi.org/10.3329/icmj.v2i1.17414 Ibrahim Cardiac Med J 2012; 2(1): 27-31

Clinical observation of placement of tympanostomy microtube to treat middle ear atelectasis

To investigate the treatment efficacy of tympanostomy microtube placement surgery for middle ear atelectasis. A retrospective analysis was conducted on 26 patients (28 ears) with middle ear atelectasis, who complained fullness or pressure in the ears.Otoscope showed tympanic membrane invagination, scattered or disappeared cone of light, tympanic membrane was pale and dull. The pure tone audiometry air-bone gap >10 dB. Acoustic immittance showed tympanic negative pressure. All the ears had atelectasis of I-III grade. Patients were performed tympanic membrane microtube placement under local anesthesia, and were followed up for 6-12 months. Twenty-five ears recovered from the fullness after operation, in which, 23 ears reverted from type "C" to type "A" in acoustic immittance tests and the pure-tone average (PTA) of hearing thresholds were decreasing from 5 to 20 dB, while 2 ears relapse after removal of the microtube. Three ears with middle ear atelectasis of III grade were ineffectiveness. All the 26 cases had no complications including middle ear infection, tympanosclerosis, and permanent perforation after removal of the microtubes. The placement of tympanostomy microtube can be used to treat middle ear atelectasis, especially to the patients with middle ear atelectasis of I-II grade as it is effective on elimination of middle ear negative pressure and remission of fullness.

Secondary Acquired Cholesteatoma after Adenoidectomy and Myringotomy

Secondary Acquired Cholesteatoma after Adenoidectomy and Myringotomy

Role of oxidative stress in chronic otitis media with effusion in children

Chronic otitis media with effusion (OME) is a common pathologic condition characterized by nonpurulent fluid in the middle ear (ME) that leads to moderate conductive hearing loss and flat tympanogram. During OME inflammatory cells generate large amounts of superoxide radicals to improve bactericidal activity. Overproduction of oxygen-derived free radicals induces oxidative damage in humans. Glutathione (GSH) is one of the major components of the antioxidant system that protects cells from oxidative stress. The aim of the study was to evaluate oxidative stress in chronic OME by investigation of ME fluids collected during myringotomy. During myringotomy, fluid was collected from the ME to evaluate lipid peroxide levels in the effusion. Immunohistochemical study was also performed to assess the anatomical features of tympanic membrane. Fifty-nine children with ME effusion without any resolution after repeated medical treatments were enrolled in the study. No morphological significant changes were observed. Lipid peroxide levels in all samples were high (mean 11.5 nmole/million cells), similar to the values found in other chronic diseases. GSH might be employed during surgery while applying ventilation tubes and after surgery to prevent oxidative stress. The high oxidant levels in chronic OME observed in our research and the improvement seen in children after antioxidant treatment suggest that oxygen-derived free radicals play an important role in chronic OME.

Say No to Adenoidectomy for Recurrent Upper Respiratory Infections

Many children with chronic or recurrent upper respiratory infections (URIs) undergo adenoidectomy with or without myringotomy tube placement. Investigators in the Netherlands evaluated the efficacy of this practice in an open multicenter randomized trial that included 111 children (age range, 1–6 years) with recurrent URIs who were selected by surgeons for treatment …

The Effect of Rat Tympanic Membrane Perforation on Oxidants/Antioxidants Balance

Myringosclerosis is a common sequel of the ventilation tube treatment of otitis media. Recent studies have established the relationship between reactive oxygen species (ROS) and myringosclerosis.The aim of this experimental study was to investigate the temporal change of oxidants/antioxidants balance at 6, 12, 24, and 48 hours after the myringotomy. Fifty healthy adult male Wistar albino rats, weighing approximate 250-300 g, were randomly separated into five groups (n = 10 rats/group): first group ,of control, nonmyringotimized and four groups myringotimized unilaterally on the left ear. The tympanic membranes were collected from sacrificed rats for biochemical evaluation of parameters of oxidants/antioxidants balance from 1st group and in 6 hours from 2nd group, in 12 hours from 3rd group, in 24 hours from 4th group and in 48 hours from 5th group. The index oxidants were malondialdehyde and carbonyl proteins and the index antioxidants were hydrogen donor ability and sulfhydril groups. Results and conclusions: The changes of oxidants/antioxidants balance and oxidative stress appear after myringotomy in 6 hours and increase in 12, 24, and 48 hours. Myringosclerosis develops promptly after myringotomy.

Potpourri of Pediatric Research: 2007

Tympanostomy tubes for otitis: They don’t improve outcomesTo improve hearing and developmental outcomes in children with otitis media, tympanostomy

Long-Term Antibiotics for the Draining Ear

Chronic otitis media with purulent otorrhea draining through a tympanic membrane perforation or a tympanostomy tube is a stubborn condition that can

Myringotomy Operation by Otoscopic Technique

Myringotomy Operation by Otoscopic Technique

Lidocaine, paracetamol: comparable for kids' myringotomy

Lidocaine, paracetamol: comparable for kids' myringotomy

EFFECTS OF TOPICAL APPLICATION OF MITOMYCIN-C AND 5-FLUOROURACIL ON MYRINGOTOMY IN RATS

EFFECTS OF TOPICAL APPLICATION OF MITOMYCIN-C AND 5-FLUOROURACIL ON MYRINGOTOMY IN RATS

Do Tympanostomy Tubes Improve Developmental Outcomes

After development of middle-ear effusion, many children have tympanostomy tubes inserted to improve hearing and possibly to improve long-term

Tympanostomy Tubes: A Review of Recent Studies

Tympanostomy Tubes: A Review of Recent Studies

Which Treatment for AOM in Children with Tympanostomy Tubes

Children with tympanostomy tubes often develop acute otitis media (AOM). Treatment options include oral and topical antibiotics alone or in combination

Adenoid Bacteriology in Otitis Media Children With Effusion

Objectives: The relationship between the adenoids and otitis media has been well documented. The purpose of this study was to document the current trends in the bacteriology of the adenoids in children with otitis media with effusion (OME). Comparisons of bacteriology of the adenoids with that of the middle ear fluid are made, and the role of adenoidectomy in treating otitis media with effusion is discussed. Methods: A prospective investigation of 44 patients with adenoid hyperplasia and OME was performed. All patients received transoral endoscopic adenoidectomy and insertion of tympanostomy tubes. The core adenoid tissue and middle ear fluid were cultured. Presumptive pathogens were identified using standard methods. Results: The age range of the patients was 3 to 14 years with a mean age of 6.95years; 31 patients were male and 13 were female. Microorganisms were isolated in the core adenoid tissue in 84% (37/44) of the patients and more than two microorganisms were isolated in 41% (20/44) of the patients. Possible pathogenic microorganisms were present in 41% (29/70) of the samples. The most common pathogenic microorganisms were Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae and Pseudomonas aeruginosa. Possible nonpathogenic microorganisms were present in59% (41/70) of the samples. Streptococcus viridans, Neisseria species and coagulase(-) Staphylococcus were the most common. Only one isolate of Neisseria species(2.9%) was cultured from the middle ear effusion. Conclusions: Our results suggest that the adenoidal reservoir of bacteria may be associated with otitis media with effusion. Although we did not find a significant association between bacteriology of the adenoids and that of middle ear effusion, a significant portion of the reservoir bacteria were pathogenic microorganisms and some of them were oxacillin-resistant or β-lactamase positive. The clinical benefits of adenoidectomy in the health management of children with otitis media with effusion should not be overlooked.