A comparison of performance of Shepard and Sheehy collar button ventilation tubes

Heaton, Judith M.; Bingham, B. J. G.; Osborne, Jonathan

doi:10.1017/s0022215100117761

Cited by 8 publications

(9 citation statements)

References 13 publications

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“…[16][17][18][19][20][21][22][23][24][25] Length of tube retention was longer in tubes that manufacturers identified as "long-term tubes." Specifically, Goode T-tubes and Paparella tubes were retained longer than Shah and Shepard tubes.…”

Section: Tympanostomy Tube Comparisonsmentioning

confidence: 99%

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Surgical Treatments for Otitis Media With Effusion: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVE: The near universality of otitis media with effusion (OME) in children makes a comparative review of treatment modalities important. This study' s objective was to compare the effectiveness of surgical strategies currently used for managing OME. METHODS:We identified 3 recent systematic reviews and searched 4 major electronic databases. Eligible studies included randomized controlled trials, nonrandomized trials, and cohort studies that compared myringotomy, adenoidectomy, tympanostomy tubes (tubes), and watchful waiting. Using established criteria, pairs of reviewers independently selected, extracted data, rated risk of bias, and graded strength of evidence of relevant studies. We incorporated meta-analyses from the earlier reviews and synthesized additional evidence qualitatively. RESULTS:We identified 41 unique studies through the earlier reviews and our independent searches. In comparison with watchful waiting or myringotomy (or both), tubes decreased time with OME and improved hearing; no specific tube type was superior. Adenoidectomy alone, as an adjunct to myringotomy, or combined with tubes, reduced OME and improved hearing in comparison with either myringotomy or watchful waiting. Tubes and watchful waiting did not differ in language, cognitive, or academic outcomes. Otorrhea and tympanosclerosis were more common in ears with tubes. Adenoidectomy increased the risk of postsurgical hemorrhage.CONCLUSIONS: Tubes and adenoidectomy reduce time with OME and improve hearing in the short-term. Both treatments have associated harms. Large, well-controlled studies could help resolve the riskbenefit ratio by measuring acute otitis media recurrence, functional outcomes, quality of life, and long-term outcomes. Research is needed to support treatment decisions in subpopulations, particularly in patients with comorbidities.

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Section: Tympanostomy Tube Comparisonsmentioning

confidence: 99%

“…[16][17][18][19][20]22,25,[60][61][62][63] Longer-term tubes related to a higher probability of otorrhea in 3 studies 16,19,60 (low SOE). Evidence about otorrhea was insufficient for other tube comparisons.…”

Section: Tympanostomy Tube Comparisonsmentioning

confidence: 99%

Surgical Treatments for Otitis Media With Effusion: A Systematic Review

et al. 2014

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“…Various studies have been carried out to see how to reduce the risk of surgical contamination during grommet insertion, and thus reduce postgrommet otorrhoea by (a) using different types of grommets [4], (b) preparation of the ear canal or use of prophylactic topical antibiotics [5][6][7], (c) use of a no touch technique [8].…”

Section: Discussionmentioning

confidence: 99%

Aseptic surgical technique and postgrommet otorrhoea

Odutoye

McGilligan

Robb

2003

International Journal of Pediatric Otorhinolaryngology

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“…This is similar to our by‐ear, non‐function rate of 45% at this time, but not to the 20% extrusion rate of antero‐inferior Shepard tubes reported by Heaton et al . (1991) 21 . The advantages, if any, of inserting bilateral as opposed to unilateral ventilation tubes have not been fully explored in children with bilateral OME.…”

Section: Discussionmentioning

confidence: 99%

The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion

2003

Clin Otolaryngol

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The study determined the effects on hearing of the status of ventilation tubes, using a combination of otoscopy and tympanometry to determine function, in children managed for bilateral persistent otitis media with effusion (OME). The subjects were aged between 3.5 and 7 years and had a documented history of bilateral OME over a 12-week watchful waiting period associated with a hearing impairment in both ears of >or= 20 dB HL. The children reported are those randomized to the two surgical arms, both of which had bilateral myringotomy, aspiration of middle ear fluid and insertion of Shepard ventilation tubes. One arm furthermore received adenoidectomy. The data were analysed 'as treated' to document therapeutic progress. Tubes confirmed to be functioning on otoscopy and tympanometry only partially alleviate the conductive impairment associated with childhood OME (AC mean 12 dB HL, SD 4; ABG 13 dB, SD 7, 3 months post operation). Thus, children with a functioning ventilation tube cannot be considered to have 'normal' hearing. Once the tube has extruded, ears that no longer have OME still have a small conductive hearing impairment (at 12 months AC 14 dB HL, SD 6; ABG 16 dB, SD 9) but this improves with time. In children with bilateral tubes, both remain functioning for a median duration of 21 weeks (IQR 10-40) and at least one for a median of 40 weeks (IQR 24-61). Tube blockage significantly (P = 0.001) increases the risk of extrusion (84% versus 44%). When inserted in children between 3.5 and 7 years for OME, the otoscopic incidence of tube infection is low (1%).

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A comparison of performance of Shepard and Sheehy collar button ventilation tubes

Cited by 8 publications

References 13 publications

Surgical Treatments for Otitis Media With Effusion: A Systematic Review

Surgical Treatments for Otitis Media With Effusion: A Systematic Review

Aseptic surgical technique and postgrommet otorrhoea

The role of ventilation tube status in the hearing levels in children managed for bilateral persistent otitis media with effusion

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