The mini-grommet and tympanosclerosis: results at two years

Dingle, Ann F.; Flood, L M; Kumar, B. U.; Hampal, S.

doi:10.1017/s0022215100122352

Cited by 10 publications

(6 citation statements)

References 16 publications

(15 reference statements)

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“…Lesser (Lesser et al, 1988) demonstrated that sites of shear stress in the tympanic membrane correlated with the areas likely to develop tympanosclerosis and suggested that a grommet of reduced mass might be beneficial. This was confirmed by our subsequent studies of mini-grommets (Hampal et al, 1991;Dingle et al, 1993). Unfortunately mini-grommets are less well retained than conventional tubes and a reduced tympanosclerosis rate was offset by earlier extrusion of the grommet and earlier recurrence of OME.…”

Section: Discussionsupporting

confidence: 53%

“…Research has suggested that tympanosclerosis confined to the tympanic membrane has no significant adverse effect upon hearing (Tos and Stangerup, 1989;Dawes et al, 1991;Dingle et al, 1993) but only very long term studies would be totally reassuring. Any modification to grommet design which avoids tympanosclerosis but allows prolonged intubation seems desirable.…”

Section: Discussionmentioning

confidence: 99%

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Tympanosclerosis and mini grommets: the relevance of grommet design

et al. 1995

J. Laryngol. Otol.

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Fifty children with otitis media with effusion undergoing grommet insertion had into one ear a Minititanium grommet inserted and into the other ear a Mini-teflon grommet. Post-operative follow-up until after extrusion of the grommets demonstrated only a small difference between the extrusion times of the two grommets (a significant difference of 41 days) and no difference in the degree of tympanosclerosis seen with each grommet. We propose that the mass of a grommet appears to play less of a role than has previously been suggested in the pathogenesis of tympanosclerosis following grommet insertion and that duration of intubation may be the most significant factor.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Tympanosclerosis and mini grommets: the relevance of grommet design

et al. 1995

J. Laryngol. Otol.

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“…Placed tubes are extruded by epithelial migration, However, a tube retained for a long time that fails to extrude naturally can cause infection, peritubal TM atrophy and permanent TM perforation [19]. Guidelines for placement of tympanostomy and intentional removal for problematic situations are relatively clear [20], but opinions on the appropriate duration of intubation vary [21][22][23] with no clear guidelines exist for the optimal time to remove asymptomatic tubes that do not cause any of the complications. Our prospective study was intended to provide a guideline based on clinical data for deciding when to remove the T-tubes.…”

Section: Change Of Conductive Hearing Loss According To Intubation Dumentioning

confidence: 99%

Timing for Removal of Asymptomatic Long-Term Ventilation Tube in Children

Abdel-NabyAwad

2015

Indian J Otolaryngol Head Neck Surg

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Otitis media with effusion (OME) is the most frequent illness in children. Surgical treatment options include ventilation tube insertion, adenoidectomy or both. Opinions regarding the risks, benefits and intubation period of ventilation tube insertion vary greatly. To determine the appropriate time for when to remove asymptomatic longterm ventilation T-tubes in children. In this prospective study, we analyzed the results of 120 pediatric patients (6-12 years) (240 ears) with persistent OME; we employed the Goode T-silicone tubes. We intentionally planned to remove the tubes at different time points of the study and divided our patients randomly into four subgroups with 30 patents (60 ears in each) according to the intubation period; group I: intubation for 6 months, group II: intubation for 12 months, group III: intubation for 18 months and group IV: intubation for 24 months. The relationship between intubation period and OME recurrence, the rate of persistent tympanic membrane (TM) perforation, granulation tissue or discharge near the tympanostomy tubes, normalization of Eustachian tube function and change of hearing level was analyzed in each patient group. The χ analysis showed that the rate of normalization of ET function was significantly higher when tubes were removed after 12-months of intubation (P = 0.002), the rate of OME recurrence was significantly higher when tubes were removed before 12-months of intubation (P = 0.004), The rate of otorrhea significantly increased after 12-months of intubation, development of granulation around tubes was significantly higher after 18-months of tube insertion. The rate of appearance of permanent TM perforation significantly increased after 18-months from tube insertion (P = 0.008). Adenoidectomy did not significantly influence the recurrence rate of OME or the rate of persistent TM peroration after tube removal. Our present results suggest that the appropriate intubation period for healing OME in children would be at 12-18 months. Also, we can conclude that longterm ventilation tubes are recommended to avoid repeated intubation and to obtain sufficient results, although their performance is not always satisfactory; mainly because of accompanying complications.

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“…Many different tympanostomy tubes have been developed with different sizes, shapes, compositions, and coatings. Dingle et al 11 analyzed grommet composition and size as a factor influencing the development of TS after ventilation tube insertion and found that the size or material of the tube did not significantly affect the development of TS. Kinnari et al 12 used albumin‐coated tympanostomy tubes in their clinical study.…”

Section: Discussionmentioning

confidence: 99%