The prevention of tympanic membrane perforation following the removal of long-term Paparella type II ventilation tubes.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to B J Bingham.
Explore the source record for details and available documents.
A discussion of the rationale of management of acute haematoma auris and a description of a simple, reliable method of management using Otoform K Silicone impression material to form ear splints.
Residual perforation following the extrusion or removal of a long-term ventilation tube may occur in between 8.5% and 25% of cases. This prospective clinical trial concerns Paparella II ventilation tubes and demonstrated that (a) extracting (pulling) a tube from the tympanic membrane gives a 6-month perforation rate of 20%, (b) excising (freshening) the edge of the defect at the time of removal decreases the 6-month perforation rate to 3%, and (c) excising the edge significantly accelerates the healing of the tympanic membrane. There was no correlation in this study between the incidence of perforation and age, sex, ear affected, tympanosclerosis, ventilation tube position, tube in situ time or discharge. The study confirmed a high rate of tympanosclerosis (76%) to be associated with ventilation tubes. Long-term discharge (68%) was identified as a problem of Paparella II ventilation tubes.
We present a paper to highlight that the investigation of dysphagia by the standard methods of barium swallow and the now routinely used fibreoptic oesophagogastroscope may miss or inadequately assess pharyngeal and hypopharyngeal causes of dysphagia and to remind that if such a cause is suspected then rigid endoscopy is required to assess or exclude the pathology.
An extremely rare case of neurilemmoma of the nasal tip is presented. The need for careful preoperative assessment is emphasised.
A rare case of a duplicate segment within a single ureter is reported and the embryology of such an anomaly is discussed.