Meta‐analysis of time to extrusion of tympanostomy tubes by tympanic membrane quadrant

2021 ◽  
Author(s):  
Omer J. Ungar ◽  
Harel Baris ◽  
Yahav Oron ◽  
Shilo Shahaf ◽  
Ophir Handzel ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Meta Analysis ◽  
Tympanostomy Tubes

Care of the Child With Tympanostomy Tubes: A Visual Guide for the Pediatrician

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 924-929
Author(s):  
Glenn Isaacson ◽  
Richard M. Rosenfeld
Keyword(s):  
Tympanic Membrane ◽  
Personal Communication ◽  
The United States ◽  
Tympanic Membrane Perforation ◽  
Nonsurgical Management ◽  
Tympanostomy Tubes ◽  
Membrane Perforation ◽  
Middle Ear Disease ◽  
Available Information

More than 2 million tympanostomy tubes are placed annually in the United States, primarily in children with chronic or recurrent otitis media refractory to nonsurgical management (J.S. Reilly, personal communication, 1994). Traditionally, the operating otolaryngologist has had the responsibility of caring for these patients, including: confirming middle ear disease, assuring tube patency, controlling refractory otorrhea, and managing complications such as tympanic membrane perforation or cholesteatoma. In response to pressures from a changing health care system, pediatricians are less able to refer children back to the otolaryngologist for routine tube surveillance, and must therefore perform it themselves, often with incomplete instrumentation and training. An approach is presented here for the care of the child with tympanostomy tubes based on the authors' combined experience with thousands of intubated children, and on available information from the pediatric and otolaryngic literature. With appropriate postoperative surveillance and follow-up care, the morbidity from tympanostomy tubes can be minimized. Although there are other ways of achieving the same goals, these time-honored methods are safe and effective. Because this is a visual guide, photographs are liberally interspersed to clarify and reinforce the written material. NORMAL TUBE APPEARANCE There are hundreds of different tube designs and materials and at least five different potential insertion sites in the tympanic membrane. This bewildering array of devices can be reduced to two general types: short-term tubes (intended to remain in the eardrum for 8 to 15 months) and long-term tubes (intended to remain in the eardrum > 15 months) (Fig 1A and B).

Closure of tympanic membrane perforation after the removal of Goode-type tympanostomy tubes: the use of silastic sheeting

1992 ◽  
Vol 106 (11) ◽  
pp. 960-962 ◽  
Author(s):  
R. G. Courteney-Harris ◽  
G. R. Ford ◽  
T. M. J. Ganiwalla ◽  
K. S. Mangat
Keyword(s):  
Tympanic Membrane ◽  
Randomized Study ◽  
Tympanic Membrane Perforation ◽  
The Other ◽  
Prospective Randomized Study ◽  
T Tube ◽  
Tympanostomy Tubes ◽  
Membrane Perforation

AbstractThe reported incidence of persistent tympanic membrane perforation after the extrusion or removal of Goodetype tympanostomy tubes varies from 3 per cent to 47.5 per cent.A prospective randomized study of 152 Goode-type T-tube removals is presented. In one group of 79 ears, the edge of the defect was just freshened, but in the other 73 ears, the edge was freshened and a small piece of 0.13 mm silastic sheeting placed over the defect. Follow-up was performed at six weeks and three, six and nine months and shows that the use of silastic sheeting increases the rate of closure of the perforation and also significantly decreases the number of persistent perforations at nine months.

Eustachian Tube Ventilatory Function in Children

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 171-177 ◽  
Author(s):  
Erdem I. Cantekin ◽  
Charles D. Bluestone ◽  
Leon P. Parkin
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Response Characteristic ◽  
Ventilatory Function ◽  
Stimulus Response ◽  
Tympanostomy Tubes ◽  
History Of ◽  
Middle Ear Disease

In order to establish a simple stimulus-response characteristic of Eustachian tube physiology in children, the tubal ventilatory function was studied. The parameters of active and passive opening of the tube were measured for three groups of patients with non-intact tympanic membranes. The group with traumatic perforations of the tympanic membrane without any history of middle ear disease had better active equilibration function than the group with chronic otitis media and perforations of the tympanic membrane and the group with tympanostomy tubes in the tympanic membrane. Quantitatively, this could be expressed in terms of residual positive pressures. In the study of repeated inflation of the middle ear, all groups had lower second opening pressures which are attributed to the effect of surface forces.

scholarly journals Human-derived acellular dermal matrix may be an alternative to autologous grafts in tympanic membrane reconstruction: systematic review and meta-analysis

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Shan Xu ◽  
Xia Sun ◽  
Ning Yang ◽  
Aihui Yan
Keyword(s):  
Cohort Studies ◽  
Tympanic Membrane ◽  
Retrospective Cohort ◽  
Meta Analysis ◽  
Acellular Dermal Matrix ◽  
Dermal Matrix ◽  
Randomized Controlled ◽  
Retrospective Cohort Studies ◽  
Autologous Grafts ◽  
Acellular Dermal

Abstract Background Human-derived acellular dermal matrix (ADM) has been widely used as an effective alternative to autologous grafts in tympanoplasty. However, evidence of ADM as an alternative to autologous grafts in the repair of tympanic membrane (TM) perforation still lacks adequate empirical evidence. Objectives To determine the clinical safety and efficacy of human-derived ADM as TM graft material for tympanoplasty. Data sources The PubMed, EMBASE, Cochrane Library, EBSCO, Ovid, Scopus, and Web of Science databases and reference lists of the retrieved articles were searched, with no language restriction. Selection criteria All randomized controlled trials and retrospective cohort studies that compared the use of human-derived ADM and autologous grafts in tympanoplasty for TM perforation were included. Data collection and analysis Two review authors independently assessed risk of bias in the included studies and extracted data. The pooled results for continuous data were reported as a mean difference (MD) and 95% confidence intervals (CI). For dichotomous data, odds risk (OR) with 95% CI was used. ChI2 statistic and Galbraith plots were used to assess the heterogeneity. Publication bias was assessed with a funnel plot and Egger’s test. Main results Five retrospective cohort studies and four randomized controlled studies with a total of 610 participants were included in the meta-analysis. No significant differences in graft success (OR: 0.71 [0.39, 1.29], p = 0.26), air-bone gap (ABG) reduction (MD: − 0.59 [− 3.81, 1.19], p = 0.51), or complications (OR: 1.23 [0.07, 20.64], p = 0.89) were found between the ADM group and autologous graft group. The use of ADM significantly shortened tympanoplasty surgery time (MD: − 16.14 [− 21.22, − 11.07], p < 0.00001) and reduced postoperative pain (MD: − 2.57 [− 3.57, − 1.58], p < 0.00001) compared with the autologous graft group. Conclusion Human-derived ADM might be an effective alternative to autologous grafts for tympanoplasty. However, some of the studies that were included in the present meta-analysis had rather low methodological quality, and more adequately designed clinical trials should be performed in the future. Graphical abstract

Perforations of the tympanic membrane following the use of Goode-Type ’long term‘ tympanostomy tubes

1988 ◽  
Vol 102 (11) ◽  
pp. 997-999 ◽  
Author(s):  
Maurice R. Hawthorne ◽  
Andrew J. Parker
Keyword(s):  
Tympanic Membrane ◽  
Retrospective Review ◽  
T Tube ◽  
Tympanostomy Tubes

A retrospective review of 64 Goode ‘T’ tube insertions is presented. These were inserted into 61 ears of 48 patients over a period of four years. At the time of review of these 61 ears, 34 tubes were found to be in situ, 27 had extruded spontaneously and three had been removed surgically. Ten ears in which the tube had been extruded or removed had central perforations of the tympanic membrane of which eight had been present for more than six months. The number of previous myringotomies or grommet insertions did not increase the likelihood of developing a perforation. Tympanostomy tubes of this type should not be used indiscriminately.

Can meta-analysis help uncertainty in surgery for otitis media in children

1991 ◽  
Vol 105 (10) ◽  
pp. 812-819 ◽  
Author(s):  
Elizabeth E. Bodner ◽  
George G. Browning ◽  
Frances T. Chalmers ◽  
Thomas C. Chalmers
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Meta Analysis ◽  
Medical Attention ◽  
Common Disease ◽  
Randomized Control Trials ◽  
Future Studies ◽  
Tympanostomy Tubes ◽  
Randomized Control ◽  
Surgical Treatments

AbstractWhile otitis media is perhaps the most common disease of childhood that receives medical attention, there is little agreement concerning the efficacy of the medical and surgical therapies employed to try to alleviate its symptoms or hasten its natural resolution. Because various surgeries including adenoidectomy, myringotomy, and insertion of tympanostomy tubes are frequently involved in the treatment of otitis media with effusion (OME), it is likely the most expensive condition being managed in national terms.In an attempt to elucidate the most appropriate management of this condition, a meta-analysis was attempted to the 12 randomized control trials of surgical treatments for OME in children, published between 1966 and 1990. Heterogeneity both in the populations and comparisons studied and in the out comes presented made meta-analysis an inappropriate method for clarifying this area of clinical uncertainty. Important elements in the design of randomized control trials that should be included in future studies of treatment for OME are therefore discussed.

scholarly journals Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 014556132110154
Author(s):  
Juntao Huang ◽  
Bing Mei Teh ◽  
Yi Shen
Keyword(s):  
Postoperative Pain ◽  
Tympanic Membrane ◽  
Meta Analysis ◽  
Operation Time ◽  
Functional Results ◽  
Cochrane Library ◽  
Surgical Approaches ◽  
Tympanic Membrane Perforations ◽  
Cartilage Tympanoplasty ◽  
Fat Plug Myringoplasty

Objective: To compare the effectiveness of butterfly cartilage tympanoplasty (BCT) with that of conventional surgical approaches in the treatment of tympanic membrane perforations. Methods: A systematic search was performed by screening the PubMed, Embase, and Cochrane Library databases up to October 31, 2020. Two coauthors independently identified studies in accordance with the selection criteria. Data were pooled and analyzed via Review Manager version 5.3 and Stata version 12.0 software. The postoperative outcomes were measured and expressed as odds ratios (ORs) and standardized mean differences (SMDs). Additionally, heterogeneity was assessed through the I2 statistic. Results: A total of 15 articles were eligible for final inclusion. The OR values for the graft uptake rate, compared to conventional tympanoplasty, were 1.12 (95%CI: 0.56-2.22, I2 = 52%, P = .75) and 1.22 (95%CI: 0.58-2.59, I2 = 0%, P = .60), and the OR compared to fat plug myringoplasty was 3.02 (95%CI: 1.04-8.77, I2 = 0%, P = .04). The qualitative analysis of the hearing results reflected significant postoperative auditory gains with no significant differences between the BCT and control groups, indicating satisfactory and similar postoperative hearing improvement. Moreover, the operation time was shortened (SMD = −2.19, 95%CI: −2.79 to −1.59, I2 = 82%, P < .05), and the postoperative pain was less with the BCT approach. Conclusion: Butterfly cartilage tympanoplasty has satisfactory efficacy in terms of anatomical and functional results in small to medium perforations. It reduces operation time and postoperative pain. However, the effectiveness on large perforation requires further assessment by well-designed studies.

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