Comparison of extrusion and patency of silicon versus thermoplastic elastomer tympanostomy tubes

Kim, Dong-Won; Choi, Sung-Won; Lee, Hyun-Min; Kong, Soo-Keun; Lee, Il-Woo; Oh, Se-Joon

doi:10.1016/j.anl.2018.09.002

Cited by 8 publications

(14 citation statements)

References 21 publications

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“…Nonserious AEs were of type and rate consistent with expectations for tympanostomy procedures. For in‐office patients, otorrhea (6.0%) or tube occlusion (3.1%) rate by ear within the first month after the procedure was similar to rates reported in the literature, despite infrequent suction of effusion. This result is consistent with the literature suggesting that suction is not necessary to ensure a patent tube or reduce otorrhea rate .…”

Section: Discussionsupporting

confidence: 83%

“…There are limited reports in the literature regarding the time course of tube retention for comparison purposes. Kim et al reported mean time to extrusion for Medtronic Paparella silicone 1.14‐mm tubes (Jacksonville, Florida USA) as 7.4 months. Soderman et al demonstrated that 39% of Donaldson silicone 1.10‐mm tubes (Atos Medical AB, Hörby, Sweden) were extruded at 12 months, and Gordts et al reported an average extrusion time of 11.3 months for Donaldson 1.10‐mm tubes .…”

Section: Discussionmentioning

confidence: 99%

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In‐Office Tympanostomy Tube Placement in Children Using Iontophoresis and Automated Tube Delivery

et al. 2020

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Objectives/Hypothesis Evaluate technical success, tolerability, and safety of lidocaine iontophoresis and tympanostomy tube placement for children in an office setting. Study Design Prospective individual cohort study. Methods This prospective multicenter study evaluated in‐office tube placement in children ages 6 months through 12 years of age. Anesthesia was achieved via lidocaine/epinephrine iontophoresis. Tube placement was conducted using an integrated and automated myringotomy and tube delivery system. Anxiolytics, sedation, and papoose board were not used. Technical success and safety were evaluated. Patients 5 to 12 years old self‐reported tube placement pain using the Faces Pain Scale–Revised (FPS‐R) instrument, which ranges from 0 (no pain) to 10 (very much pain). Results Children were enrolled into three cohorts with 68, 47, and 222 children in the Operating Room (OR) Lead‐In, Office Lead‐In, and Pivotal cohorts, respectively. In the Pivotal cohort, there were 120 and 102 children in the <5 and 5‐ to 12‐year‐old age groups, respectively, with a mean age of 2.3 and 7.6 years, respectively. Bilateral tube placement was indicated for 94.2% of children <5 and 88.2% of children 5 to 12 years old. Tubes were successfully placed in all indicated ears in 85.8% (103/120) of children <5 and 89.2% (91/102) of children 5 to 12 years old. Mean FPS‐R score was 3.30 (standard deviation [SD] = 3.39) for tube placement and 1.69 (SD = 2.43) at 5 minutes postprocedure. There were no serious adverse events. Nonserious adverse events occurred at rates similar to standard tympanostomy procedures. Conclusions In‐office tube placement in selected patients can be successfully achieved without requiring sedatives, anxiolytics, or papoose restraints via lidocaine iontophoresis local anesthesia and an automated myringotomy and tube delivery system. Level of Evidence 2b Laryngoscope, 130:S1–S9, 2020

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

In‐Office Tympanostomy Tube Placement in Children Using Iontophoresis and Automated Tube Delivery

et al. 2020

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“…However, the authors also mentioned that thermoplastic elastomer VTs had more plugging events than silicone VTs, which is probably due to the smaller diameter. 22 Therefore, we believe all these factors, including patient condition, tube diameter, and tube materials, must be considered together for the readers to decide which VT would be best according to patients' clinical conditions and needs. The study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

Factors Related to Ventilation Tube Extrusion Time in Children and Adults

et al. 2021

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Background and Objective: The aim of this study was to investigate the factors affecting extrusion time in both children and adults with ventilation tube (VT) insertion, providing useful information for clinicians for better decision-making, follow strategy, and potentially improve clinical outcomes for these patients. Methods: Data from patients receiving myringotomy with VT insertion from January 1, 2007, to June 30, 2012, were retrospectively collected and analyzed by the end of 2018. Various factors, including age, gender, history of VT insertion, tympanogram, size of VT used, local finding of tympanic membrane, hypertension, diabetes mellitus, hyperlipidemia, and postoperative ear infection, were included and analyzed to examine the effects of these factors on extrusion time. Results: A total of 447 patients were included in this study (Child group–Adult group = 237:210). The overall average extrusion time was 225.85 days. In the subgroup analysis, the average time was 221.3 days and 231.0 days for children and adults, respectively. The results showed that the VT extrusion time was significantly longer in participants without a history of VT insertion and in those where larger sized VTs were inserted in both age-groups. Male gender had an influence on extrusion time in children. In addition, a history of VT insertion and VT size were determined to be factors related to extrusion before 12 months in children. Conclusion: History of VT insertion and VT size were significantly related to VT extrusion time in both children and adults and defined as factors associated with extrusion before 12 months in children. The findings suggest avoiding VT with a diameter < 1 mm and considering an appropriately larger size in patients with a history of VT insertion to optimize VT retention.

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“…The different designs and materials have slightly different rates of occlusion (clogging), infection, duration of function, and rates of persistent perforation after extrusion. [17][18][19] None is clearly superior (Figure 3).…”

Section: The Best Tympanostomy Tube/the Best Way To Place Itmentioning

confidence: 96%

Tympanostomy Tubes—A Visual Guide for the Young Otolaryngologist

Isaacson

2020

Ear Nose Throat J

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Objectives: To illustrate some of the common dilemmas in tympanostomy tube care and describe time-tested ways to address them. Methods: Computerized literature review. Results: Issues including the correct diagnosis of recurrent acute otitis media, tympanostomy tube types and techniques for tube placement, management of tube clogging and otorrhea, and methods for tube removal and patching are illustrated. Conclusions: Tympanostomy tube placement is the most common surgery performed in children requiring general anesthesia. While some elements of tympanostomy tube care have been addressed in clinical studies, much of clinical practice is guided by shared experience.

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Comparison of extrusion and patency of silicon versus thermoplastic elastomer tympanostomy tubes

Cited by 8 publications

References 21 publications

In‐Office Tympanostomy Tube Placement in Children Using Iontophoresis and Automated Tube Delivery

In‐Office Tympanostomy Tube Placement in Children Using Iontophoresis and Automated Tube Delivery

Factors Related to Ventilation Tube Extrusion Time in Children and Adults

Tympanostomy Tubes—A Visual Guide for the Young Otolaryngologist

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