Should we aspirate middle-ear effusions prior to insertion of ventilation tubes?

Laina, V; Pothier, David D.

doi:10.1017/s0022215106002118

Cited by 14 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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 . Resolution of effusion and tube patency rates at the 3‐week follow‐up were similar for ears that had serous or mucoid effusions at baseline.…”

Section: Discussionsupporting

confidence: 90%

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

et al. 2020

View full text Add to dashboard Cite

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

show abstract

Section: Discussionsupporting

confidence: 90%

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

et al. 2020

View full text Add to dashboard Cite

show abstract

“…It was not possible to verify any association between the development of myringosclerosis and the presence and the type of effusion (mucous or serous); the intra-operative hemorrhage (as described by Spree et al [23] and Parker et al [16]); the myringotomy incision orientation or the middle ear aspiration (discordant with the conclusions of Liana et al [24]). …”

Section: Discussionmentioning

confidence: 89%

Predictive factors for the appearance of myringosclerosis after myringotomy with ventilation tube placement: randomized study

Branco

Monteiro

Paço

2016

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Myringotomy with the insertion of ventilation tubes is the most frequent surgical procedure performed in children, and the appearance of myringosclerosis is one of its most frequent long-term complications. The objective of this study is to identify clinical factors and technique variations that may have a relation with the appearance of myringosclerosis, after tube insertion. Patients submitted to myringotomy with transtympanic short-term tube insertion were studied in a longitudinal prospective and analytical cohort study with the prospective randomized open, blinded endpoint (PROBE) methodology, to study the influence of the location of myringotomy (anterior-inferior quadrant or posterior-inferior), directions of the incision (radial or nonradial) and aspiration or not of the middle ear. Our study included 156 patients (297 ears). Myringosclerosis was observed in 35.7 % of the operated ears. It appeared more often in patients with greater number of otitis (p = .001) and with greater number of otorrhea episodes (p = .029) and in patients in whom the tympanogram after the tube extraction was type A (according to Jergeŕs classification) (p = 0.016). We identified myringosclerosis in less patients, if the tube was in the tympanic membrane for less than 12 months (p = .009). Myringosclerosis was present more extensively if the tympanic incision was located in the anterior-inferior quadrant, with tympanic involvement superior to 25 % (p = .015). The results observed prove that, underlying the appearance of myringosclerosis, there exists an early inflammatory or infectious process and a final cicatricial process. It was also found that when myringotomy is made in the anterior-inferior quadrant, myringosclerosis appears in a higher percentage of the tympanic membrane; therefore, it is not recommended to do the incision in this quadrant, because it may lead to a reduction of the tympanic membrane vibration.

show abstract

“…B. Sichelmesser) oder als laserassistierte Myringotomie durchgeführt. Danach ist das Sekret aus der Paukenhöhle abzusaugen [15]. Bei saniertem Epipharynx und bei dünnflüs-sigem Paukensekret nach Parazentese ist davon auszugehen, dass eine weitere Sekretdrainage über den natürlichen Weg der Tuba auditiva erfolgen kann und eine zusätzliche Paukenröhrcheneinlage häufig nicht notwendig ist.…”

Section: Operativunclassified

Leitlinie „Seromukotympanum“ – Langfassung

Lautermann

Begall

Hilger³

et al. 2012

HNO

View full text Add to dashboard Cite

Should we aspirate middle-ear effusions prior to insertion of ventilation tubes?

Cited by 14 publications

References 6 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

Predictive factors for the appearance of myringosclerosis after myringotomy with ventilation tube placement: randomized study

Leitlinie „Seromukotympanum“ – Langfassung

Contact Info

Product

Resources

About