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At least 37 records · Page 2Linked to original sources
PubMed1979

Middle ear ventilation in conjunction with adenotonsillectomy.

This report continues the evaluation of the use of a ventilation tube in the middle ear at the time of adenotonsillectomy. This series of 72 cases has been followed for 1 to 3 years. Each patient had bilaterally similar middle ear effusions. A myringotomy was performed in both ears. In one of the ears a ventilation tube was inserted, the other ear acting as a control. In 3 out of 4 of the patients in this study, adenotonsillectomy and evacuation of the middle ear fluid were sufficient to clear the middle ear indefinitely, and the use of the ventilation tube was redundant.

Adenoidectomy↗
PubMed1977

A rare complication of use of the middle ear ventilation tube (PVC).

Purulent otitis media was observed following operations for insertion of middle ear ventilation tubes by the same surgeon in 2.2% of 226 patients. Conservative treatment given with the tube still in situ rarely effected cure, whereas removal of the tube brought about prompt resolution and perforation closure, The cause of these infections remains unknown, but adverse reaction of the mucous membrane to polyvinylchloride could be regarded as a possible cause.

Ear, Middle↗
PubMed1993

Middle ear ventilation with HydroxylVent tube: review of the initial series.

Thirty HydroxylVent tubes were implanted in twenty-seven patients. The chief indications were unresolving eustachian tube dysfunction, with either collapse or perforation of the tympanic membrane. Every patient had undergone a lengthy course of treatment with conventional ventilation tubes. Twenty ears (66%) showed good results, with prolonged ventilation and restoration of middle ear function. Two tubes appeared to be open, with the development of a pinpoint perforation of the drum. Eight tubes occluded as a result of displacement of the tube, middle ear pathology, or debris. Indications and techniques of management are discussed, along with an analysis of complications.

Adolescent↗
PubMed1980

[Short- or long-term middle ear ventilation? (author's transl)].

In this retrospective study the results of long and short term middle ear ventilation are discussed by comparison of recurrence and frequency of reoperation. It is obvious that only long term middle ear drainage can lead to a satisfactory and permanent therapy success.

Adolescent↗
PubMed1977

Middle ear ventilation in conjunction with adenotonsillectomy.

If the tonsils and adenoids are causing eustachian tube dysfunction with middle ear effusion, the need for a ventilation tube at the time of the T&A and myringotomy is unresolved. Thirty-one patients with bilateral symmetrical middle ear effusion had T&A and myringotomies. In one ear, a ventilation tube was inserted; the other ear acted as a control. In addition to the clinical impressions, preoperative and serial postoperative audiograms and tympanograms are compared through a 12-month time frame. Discussion is presented regarding middle ventilation at the time of the primary operation.

Adenoidectomy↗
PubMed1990

T-tube with tragus cartilage flange in long-term middle ear ventilation.

This was a study of the use of tragus cartilage as a flange for a T-tube in the hope of achieving long-term middle ear ventilation. This procedure was performed on 31 ears in 25 patients. Average length of follow-up was 24.2 months, ranging from 6 to 39 months. Five patients had tympanomastoid procedures done in conjunction with the cartilage tube. One of the patients with a tympanomastoid procedure had rejection of the T-tube and cartilage at 11 months postoperatively. None of the tubes without another procedure was rejected.

Bioprosthesis↗
PubMed2001

Medium-term middle ear ventilation with self-manufactured polyethylene T-tubes for the treatment of children with middle ear effusion.

We present the results of the insertion of self-made polyethylene T-tubes for a period of 15-24 months for the treatment of chronic middle-ear effusion. We compare the outcome of our patients to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time. In a retrospective review of 603 T-tubes inserted in 306 children up to the age of 12 years, charts were reviewed for age, sex, surgical procedure performed, duration of ventilation and complications. In all cases the indication for surgery was chronic middle-ear effusion. The tubes were electively removed by the authors after 15-24 months of ventilation. Spontaneous extrusion was considered a complication. The mean period of ventilation was 20 months. Post-operative otorrhoea was experienced in 6.6 per cent of ears; 4.8 per cent of tubes extruded spontaneously, whereas 3.15 per cent had to be removed earlier than originally planned; 4.9 per cent of ears were re-ventilated at a later date, and 1.49 per cent of ears developed a persistent perforation. We demonstrate that the outcome of patients treated with our self-manufactured tubes for a period of 15-24 months is, in many respects, better or at least comparable to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time, and that the many complications associated with the conventional T-tube can be reduced. We suggest that our favourable outcome may be due to the duration of ventilation, which was controlled to be shorter than the conventional long-term T-tubes and longer than that of grommets.

Child↗
PubMed1979

Use of middle ear ventilation tubes in recurrent acute otitis media.

A method of treatment of recurrent acute otitis media with polythene middle ear ventilation tubes in young children is presented. 56 ears in which infection had persisted for one to six months despite antibiotic therapy and multiple myringotomies were included in the study. The tubes were inserted under topical anaesthesia and cure within one week was obtained in 73 per cent of ears. In another 9 per cent the otorrhoea stopped within 3 weeks, but in 18 per cent reinsertion of the tube became necessary and in this latter group 11 per cent resolved in two weeks following adenoidectomy as well. In 7 per cent the problem remained unresolved. Therefore with this regimen a total of 93 per cent of recurrent infections settled. It is emphasized that the ventilation tube should remain 'in situ' for over 3 months.

Acute Disease↗
PubMed1998

Pathophysiological and therapeutic considerations of otitis media with effusion from viewpoint of middle ear ventilation.

Using nitrous oxide, we examined the gas exchange function through the middle ear mucosa in ears with otitis media with effusion (OME) in children, and found the function to be impaired in 50% of them. The size of the mastoid was significantly smaller in ears with negative gas exchange function than those with positive function, and the presence or absence of the function was even more significantly correlated with the presence or absence of aeration in the middle ear. Furthermore, the presence or absence of aeration in ears with OME was found to be significantly correlated with their prognosis (response of OME to antibiotics treatment) and also with the presence or absence of eardrum mobility examined by a pneumatic otoscope. Finally, after myringotomy and removal of effusion, the gas exchange function recovered in most of the ears with impaired function. These results indicate that the eardrum mobility test may serve as an appropriate indicator for the surgical treatment for OME.

Child↗
PubMed1987

Gas composition of the normal and the ventilated middle ear cavity.

Epidemiologic and controlled studies indicate that late minimal hearing impairment is a sequelae after the use of a ventilation tube in early childhood. The patho-physiology is unknown, but abnormal middle ear gas composition might be important. Therefore it is mandatory to measure middle ear gas composition in order to understand the gas exchange in the normal middle ear, as well as the change in gas composition associated with ventilation tubes. Accordingly, the aim of this study was to measure middle ear gas composition both in the physiologic state and in artificial ventilation by a transtympanic tube. Employing puncture of the typanic membrane, through a liquid seal, we aspirated 300 microliters of middle ear gas. The procedure was carried out under the otomicroscope on adults without any anesthesia. A total of 58 normals participated, along with 10 persons with unilateral ventilation tubes and 1 with a patent Eustachian tube. The mean values of physiologic state were: Partial pressure of oxygen in the middle ear cavity = 39 mm Hg, and partial pressure of carbondioxide in the middle ear cavity = 48 mm Hg. The mean values of artificially ventilated ears were: Partial pressure of oxygen in the middle ear cavity = 138 mm Hg, and partial pressure of carbondioxid in the middle ear cavity = 15 mm Hg. The total imprecision was 4.2/4.4 mm Hg and the accuracy seems fair,--especially because we found a quasi equilibrium to the "most probable value", the venous blood gases. It is concluded that artificial ventilation of the middle ear cavity, with a ventilation tube increases the oxygen content of the middle ear cavity with a factor 3.2. This constitutes a relative hyperoxic atmosphere with a subsequent possibility for a toxic tissue damage.

Adolescent↗
PubMed1996

[Transitory evoked otoacoustic emissions and distortion product emissions in disorders of middle ear ventilation].

Both the amplitude and power spectra of otoacoustic emissions are affected by the transfer properties of the middle ear. This prospective study examined the influence of eustachian tube dysfunction on transiently evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs). In all, 18 ears were studied that exhibited negative middle ear pressures with or without middle ear fluid. Measurements were performed at the time of diagnosis during the recovery stage, and after the middle ear became normally ventilated. Findings showed that TEOAE and DPOAE levels increased while airbone gaps were reduced by an average of 8 dB after negative middle ear pressures returned from -400 daPa to a normal state. There was a tendency for negative middle ear pressure to affect DPOAEs more in the 1-kHz region than in higher frequencies. By contrast, TEOAEs and airbone gaps were more uniformly affected across the entire frequency range. These results for ears with eustachian tube dysfunction were somewhat different from those results of studies obtained in healthy ears tested during experimental changes in middle ear pressure.

Adolescent↗
PubMed1985

A comparison of retention and complication rates of large-bore (Paparella II) and small-bore middle ear ventilating tubes.

Large-bore myringotomy tubes are usually reserved for the treatment of refractory middle ear effusion. Theoretically, they have an extended intubation time and a higher complication rate. There is, however, scant support of this in the literature. The duration of intubation, efficacy, and complication rates of the large-bore Paparella type II tube were compared with Paparella type I, Shepard, and Armstrong tubes. The study included 242 patients with 600 intubations. In addition, a subpopulation of patients receiving their initial intubation during this study was reviewed. Findings were similar for both groups. Paparella type II tubes had a prolonged period of intubation and a decreased reintubation rate when compared with the smaller bore tubes. Larger bore tubes had an increased complication rate when compared with the smaller bore tubes. Complications included occasional or frequent otorrhea and an increased rate of permanent perforation of the tympanic membrane. There was no instance of cholesteatoma formation secondary to intubation. Guidelines are presented for the use of the Paparella type II tube.

Adolescent↗
PubMed1977

Middle ear ventilation after acute otitis media.

The investigation includes 43 children (82 ears) with acute otitis media who were treated with paracentesis and antibiotics. The middle ear pressure was measured 7 days, 14 days, 1 month, and 2 months after the otitis. A follow-up examination was performed 4-12 months after the otitis. The normalization process was extremely slow: 3 months after the otitis only 37% of the ears had a pressure between 0 and -50 mm H2O, and 24% had flat curves and chronic secretory otitis. 3-12 months after, 49% of the ears had a normal pressure. A discussion on whether the middle ear ventilation had been reduced before the present otitis, or whether the slow normalization process is due to the changes in the mucous membrane is presented. The first assumption seems to be more probable. The significance of poor ventilation in the occurrence of recurrency is emphasized. Tympanometry is recommended 1-3 months after otitis, especially in recurrent otitis media.

Acute Disease↗
PubMed1995

[Middle ear ventilation with the Otovent latex membrane system].

Epidemiological studies have shown that up to 80% of all pre-school children develop Eustachian tube dysfunction with middle ear effusion and corresponding conductive hearing loss. The therapy of choice for hyperplastic adenoids is adenoidectomy, often in combination with paracentesis. The objective of this study was to determine whether regular middle ear aeration (Otovent-system) could obviate the need for paracentesis. To this end treatment of 146 children from four to ten years old was conducted within the guidelines of a study protocol. In one group of children, Otovent-supported middle ear aeration was carried out before and after adenoidectomy. In the control group, adenoidectomy was followed by paracentesis. Parents and children were then assigned to follow-up treatment. As additional supportive therapy, children in both groups received decongestant nose drops and a mucolytic agent for a period of 2 weeks. The success of the treatment was evaluated by tympanometry, tone-wave audiometry and ear microscopy. The patients were followed-up at intervals of two and four weeks after the initiation of treatment. The results show that within the study time frame, Otovent treatment compares well to paracentesis. In summary, regular Otovent-supported aeration of the middle ear in many cases can be an alternative to paracentesis.

Child↗