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At least 109 records · Page 6Linked to original sources
PubMed1985

Sequelae of ventilation tubes following tonsillectomy.

The insertion of middle ear ventilation tubes results in persistent scarring in a significant number of the tympanic membranes incised. The present study was done in order to compare the occurrences of tympanic membrane sequelae following ventilation tube insertions in a group of patients with intact tonsils with that of a tonsillectomized group. The study population had been treated with ventilation tubes 3-5 years previously because of middle ear effusions. A total of 104 patients were re-examined (follow-up rate, 85%). Otomicroscopy was performed by examiners who had no prior knowledge of the patient's past history of ear disease or treatment. The results were categorized by a simplified scoring system. It was found that 60% of the tympanic membranes showed pars tensa abnormalities outside the previous site of the tube. The occurrence of pars tensa tympanosclerosis was more prevalent in tonsillectomized patients. This latter observation is probably a secondary occurrence. However, the high incidence of sequelae following insertions of ventilation tubes calls for their restricted usage.

Child↗
PubMed1993

Secretory otitis media and mastoid air cell development.

Controversy continues over the factors involved in the development of the mastoid air cell system (MACS). This study examines the effect of persistent secretory otitis media with effusion (SOME) on the development of the MACS. Thirty-one children, aged 4, were drawn from a cohort of cleft palate children in a multi-centre, prospective otological study set up in 1984. The initial presence of SOME was assessed by otoscopy, tympanometry and bilateral myringotomy, performed under the same anaesthetic as surgical repair of the cleft lip or palate. Only one ear in each child was ventilated with a tube and the other, the control ear, was assessed by regular follow-up otoscopy and tympanometry. The persistence of SOME after palate repair in over 70% of the non-ventilated ears in 4 years olds and the presence of a contralateral ventilated middle ear provides the perfect model for assessing the effect of SOME on MACS development. Plain, lateral mastoid X-rays were assessed by planimetry to give a well accepted measurement of mastoid pneumatization. Nine children were excluded from analysis as they did not meet the strict criteria of one persistently ventilated middle ear and one with persistent SOME. 22 children (44 ears) were available for analysis, 9 children were tubed at 3 months and 13 were tubed at 12 to 16 months. In 19 of the 22 ears the mastoid air cell system was larger on the tubed side.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1989

[Partial oxygen tension of middle ear cavity in a normobaric environment].

The present theory of eustachian tube function and middle ear ventilation posits that oxygen absorbed by the middle ear mucosa causes negative middle ear pressure which is relieved by periodic opening of the eustachian tube during swallowing and yawning. Measured by a PO2 sensor (Clark type) inserted into the middle ear cavity of normal adults through the eustachian tube, the partial oxygen pressure of the tympanic cavity was found 53.7 +/- 6.5 Torr (N:22). It was about one-third of ambient pressure (about 150 Torr), and showed no change when the eustachian tube was opened by swallowing. Our second study measured the effect of alterations in the systemic arterial blood oxygenation on middle ear gas exchange in 23 guinea pigs ventilated using 21% (room air), 50%, 70% and 100% oxygen at constant carbon dioxide blood gas tension. Partial oxygen tension (PO2) of middle ear cavity was measured by inserting a PO2 sensor into the tympanic bulla through a bore hole. The following results were obtained: (1) PO2 of the middle ear cavity was 39.3 +/- 2.2 Torr at room air, 42.2 +/- 0.84 Torr at 50%, 46.6 +/- 1.1 Torr at 70% and 54.5 +/- 3.7 Torr at 100% oxygen breathing. (2) There was a significant correlation between PO2 of the middle ear cavity and systemic arterial hyperoxygenation noted. Y = 30.79 + 0.056.X (r = 0.9440) (3) The rate of oxygen diffusion in the middle ear cavity was 2.665 x 10(-5) ml/min/cm2 and the rate of oxygen absorption in the middle ear space was 2.874 x 10(-5) ml/min/cm2. No significant difference between the rate of diffusion and that of absorption of oxygen in the middle ear cavity was noted. In our third study, electron microscopy shows that the submucosal capillaries of the human mastoid cells are structures which facilitate the intra- and extravascular transport of substances. It is known from these results that tympanic cavity pressure is kept equal to ambient pressure, or slightly higher to atmospheric pressure, by the respiratory function of the middle ear and mastoid cells so that outflow of air from the tympanic cavity to the pharyngeal orifice occurs during the ventilation of the eustachian tube at ambient pressure and inflow of air from the pharynx to the tympanic cavity is prevented in the absence of environmental pressure changes. The middle ear cavity has respiratory function, and in particular, such function of the mastoid cavity, which is larger in volume than the tympanic cavity, plays a significant role.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1991

Complications following ventilation of the middle ear using Goode T tubes.

This is a 3.5-year retrospective review on the insertion of 210 Goode T tubes into 182 ears of 93 patients. Otorrhea was noted postoperatively in 35.2% of the ears treated, with chronic drainage lasting longer than 4 months developing in more than 7% of the cases. Perforations were found in 34 ears (18.7%) following removal or extrusion of the T tubes; in 13 (7.1%) of these patients, chronic perforations requiring tympanoplasties developed. The literature was screened for additional studies addressing the complications associated with tympanostomy tubes. The documented incidence of perforations between conventional tubes and Goode T tubes was emphasized, and comparisons were made. Our findings indicate that, even with the immediate placement of paper patches following removal of all Goode T tubes, the percentage of tympanic membrane perforations resulting from the use of Goode T tubes is significantly greater than previously reported.

Adolescent↗
PubMed1996

Laser-assisted tympanostomy.

Laser-assisted tympanostomy (LAT) was performed in 70 ears to ventilate the middle ear space without using a pressure-equalizing tube. Using a CO2 laser attached to an operating microscope with a Microslad (microscope laser adaptor device), tympanostomies of 1.0 to 3.0 mm (average, 1.6 mm) in diameter were created and remained patent for an average of 3.14 weeks. Patency time was directly related to the size of the opening. Nearly all (97.9%) of the tympanostomies healed with no noticeable scarring and no persistent perforations. Seventy-eight percent of patients at the Florida Ear & Sinus Center (FESC, Sarasota, Fla.) and 84% of patients at the Head & Neck Surgery Group (New York) showed no evidence of recurrent effusion after a minimum follow-up of 3 months. LAT appears to be a safe, cost-effective procedure which can easily be performed in an office setting when bloodless opening in the tympanic membrane is needed for either treatment or diagnosis using endoscopes.

Adolescent↗
PubMed1976

Rational management of middle ear effusions in the cleft palate patient.

Middle ear effusions are common prior to surgical repair of a congenital cleft of the secondary palate. The insertion of middle ear ventilating tubes will result in an aerated middle ear, but significant complications will also occur. A review of 57 infants suggests that these ventilating tubes rarely need to be inserted prior to palatal closure but only if there is persistence of middle ear fluid three months after such surgery.

Adolescent↗
PubMed1986

[The effect of swimming on nasal patency and tubal function in children. Prospective 24-week cross-over study in 154 children].

This prospective cross-over study involving 154 healthy school children over a time span of 24 weeks revealed a favorable influence of swimming on nasal patency and tubal function in children. The positive influence of bathing on middle ear ventilation seems to be of shorter duration than that on nasal resistance. Tympanogram distribution and nasal resistance are most favorable in girls, older children and in the spring-summer period. A good nasal patency is often associated with a good middle ear ventilation. Advising children against swimming because of sinusitis and otitis is probably not justified.

Acoustic Impedance Tests↗
PubMed1996

Eustachian tube dysfunction.

There are several types of eustachian tube dysfunction, including obstruction and abnormal patency. This article presents an update on several selected areas of eustachian tube function and dysfunction, including surfactants, cleft palate, tympanic membrane atelectasis, abnormal eustachian tube patency, and long-term middle ear ventilation.

Cholesteatoma, Middle Ear↗
PubMed2000

Role of otoscan-assisted laser myringotomy in hyperbaric oxygen therapy.

Patients undergoing hyperbaric oxygen (HBO2) therapy often experience middle ear barotrauma. Not infrequently this disrupts therapy and may require myringotomy tube placement. A new, simple, office-based procedure known as OtoScan Laser Assisted Myringotomy (OtoLAM) provides temporary middle ear ventilation, which offers significant potential benefis for HBO2 patients. Five patients whose middle ear disease complicated their HBO2 therapy have undergone nine OtoLAM procedures in 11 ears. All patients tolerated the procedure without complications and immediately returned to HBO2 treatment. Based on this preliminary experience, we recommend OtoLAM for selected HBO2 patients with problematic middle ear dysfunction.

Adolescent↗
PubMed1983

[Functional results of tympanum drainage in chronic seromuco-tympanum--Clinical course up to 2 years following the operation].

The hearing capacity of 95 children with chronic seromuco-tympanum (SMT) treated with middle-ear ventilation tubes was studied preoperatively and for a period of up to two years after the operation. A total of 510 audiograms with the threshold of air conduction and bone conduction were evaluated. The pre-surgery audiogram shows on the average an air-bone gap of 30 dB. In the first post-surgery audiogram the air-bone gap was improved on the average by 15-20 dB. The observation carried out over a period of two years shows that in general this improvement of the hearing capacity is preserved. The treatment of SMT by middle-ear ventilation tubes and the resulting improvement of the hearing capacity prevents the negative effects on children's acquisition of speech and on their intellectual development.

Adolescent↗
PubMed1986

Long-term tympanic ventilation by Per-Lee tube.

The fate of 32 Per-Lee ventilation tubes inserted by a single surgeon for secretory otitis media in children and adults is analysed over a 15-year period. There were no extrusions and 25 tubes were still functional at the time of the survey. The total ventilation time achieved by the 32 tubes was over 157 years. Seven tubes were removed on account of either obstruction or infection. Spontaneous healing of the tympanic membrane was uncertain following removal of the tube and a considerable degree of scarring was inevitable. Hearing improvement occurred while the tube was functioning and there were no cases of hearing deterioration. It is concluded that the Per-Lee tube is a suitable prosthesis for long-term middle-ear ventilation.

Adult↗
PubMed2000

Laser-assisted myringotomy for otitis media: a feasibility study with short-term followup.

Intermediate-duration middle ear ventilation appears to be a good treatment option for selected children with otitis media. Laser-assisted myringotomy is one way to provide such ventilation. It can provide prompt pain relief and resolution of middle ear effusion and effusion-related hearing loss, and it can provide an opportunity for surveillance of antibiotic-resistant organisms. We performed laser-assisted myringotomy on 97 ears of 54 children over a 5-month period. All children had acute or recurrent otitis media or persistent middle ear effusions. Our experience suggests that laser-assisted myringotomy is a feasible treatment option for selected patients. Practitioner experience and patient and family considerations will contribute to the decision whether to use general or topical anesthesia.

Anesthesia↗
PubMed1994

[Changes in transitory evoked otoacoustic emissions and acoustic distortion products in disorders of eustachian tube ventilation].

Middle ear impedance plays an important role in the retrograde middle ear transfer and interpretation of otoacoustic emissions (OAE). Changes of emission spectra and reproducibility or absence of sound emissions can be caused by middle ear dysfunction. To avoid misinterpretation, especially in infant screening, we combined measurements of transiently-evoked otoacoustic emissions (TEOAE), distortion products (DPOAE) and middle ear pressure. With a single acoustic probe ear canal baro-pressure was adjusted individually to the middle ear pressure, allowing OAE to be measured at maximum compliance of the middle ear. Fifty children (ages, 3-8 years) were examined with hypoventilation of the middle ear. Twenty-five normally hearing adults were also studied. Positive and negative middle ear pressures significantly attenuated the amplitude of low-frequency OAE (< 2 kHz), whereas high-frequency emissions were stable. Individual adaptations of static ear canal pressure eliminated these alterations of TEOAE and DPOAE.

Acoustic Impedance Tests↗
PubMed2000

["Fuldaer ventilation surgery"--a surgical concept in severe ventilation disorders of the middle ear].

BACKGROUND: This report presents the long-term results of a special surgical technique in cases of persistent severe dysfunction of the Eustachian tube. PATIENTS AND METHODS: We performed this operation on 16 patients (18 ears) between 1982 and 1997. Almost all patients had undergone previous surgery. This included myringotomies and tube insertions, adenoidectomies, tonsillectomies, myringoplasties and mastoidectomies, sinus surgeries, and an operation on a cleft palate. The concept developed by one coauthor (Draf) combines different methods to improve ventilation of the middle ear and protect the eardrum against partial vacuum. The concept combines mastoidectomy, posterior tympanotomy, and removal of the incus and the head of the malleus with an interposition of the incus. The tympanic membrane is then stabilized with a cartilage-perichondrium graft, and a tube is placed leading from the tympanic cavity to the nose (Wright-tube). A T tube may also be used. The procedure was varied slightly on occasion depending on intraoperative findings. RESULTS: Thirteen patients (15 ears) were available for audiometry at a minimum of 5 months after surgery until 14 years (mean duration of 6.2 years). We compared preoperative and postoperative air-bone gaps. They were measured for the three speech frequencies (500, 1000, and 2000 Hz) at 5 dB intervals. The average preoperative air-bone gap was 25.7 dB versus 18.2 dB postoperatively. This represents an improvement of 7.5 dB. Seven of fifteen ears required revision. Six ears required one revision procedure each (three for cholesteatoma, one for myringitis, one for discharge due to a narrow external auditory meatus, and one for mastoiditis). Another patient required three revision procedures (one for mastoiditis and the other two for cholesteatoma). CONCLUSION: This concept can help prevent cholesteatoma and improve hearing in more than 50 per cent of severe cases of dysfunction of the Eustachian tube.

Adolescent↗
PubMed1984

Reconstruction of the middle ear with tragal cartilage.

A surgical technique for reconstruction of a well-ventilated middle ear space using tragal cartilage has been developed. Our technique was designed so as to secure an atticoantrum cavity and a complement of posterior tympanic annulus with a cartilage. This technique can be utilized in a radical mastoidectomy cavity at an original surgery and at a revision.

Adolescent↗
PubMed2000

A planimetric study of therapy-dependent development of temporal bone pneumatization in secretory otitis media.

The present study is based on the results of a planimetric investigation of temporal bone pneumatization in 43 children. Radiological and clinical follow-up studies 10 years after therapy for secretory otitis media indicate an adaptation in the size of pneumatization to an almost normal area. The increase shows that a myringotomy is sufficient in cases of serous effusion, whereas a mucous fluid requires long-term middle ear ventilation.

Adolescent↗