Postoperative cares after tympanostomy tubes for chronic otitis media with effusion

Bibliographic Details
Main Author: Subtil, João Eduardo Castro Campos Brito
Publication Date: 2019
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/60499
Summary: A pedido do Autor o conteúdo publicado em revistas com reserva de direitos
id RCAP_9521fd954432bcc53e2e8e3698fa617b
oai_identifier_str oai:run.unl.pt:10362/60499
network_acronym_str RCAP
network_name_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository_id_str https://opendoar.ac.uk/repository/7160
spelling Postoperative cares after tympanostomy tubes for chronic otitis media with effusionEar Protective DevicesMiddle Ear VentilationOtitis Media with EffusionMyringotomyPostoperative CareQuality of LifeSwimmingComputerized Fluid Dynamics.Ciências MédicasA pedido do Autor o conteúdo publicado em revistas com reserva de direitosABSTRACT: Tympanostomy tube insertion is the second most common surgery in children, and is mostly indicated for recurrent otitis media, or for chronic otitis media with effusion (OME). Almost every surgeon prescribes water precautions after surgery because of fear of water causing middle ear inflammation. These precautions include at least wearing ear plugs and head bands while swimming, showering or bathing. However, the evidence for such pleas has been questioned. Some authors, weighting also the impact on quality of life, economic burden, and the weak evidence of benefice from such precautions, have been dropping these measures. We proposed to evaluate how deep must one submerge the head to allow water passing through the tube in the tympanic membrane; to evaluate whether such precautions have relevant effect on quality of life; and whether there is any difference between prescribing water precautions or not. Using a computerized fluid dynamics model, we found that on reasonable depths and common conditions, water is not passing the ventilation tube. With this model we determined that including the auditory (pharyngotympanic) tube mechanism in the model is critical. Secondarily, we also learned, using the model, that on surface conditions, increasing the external auditory canal (external acoustic meatus) pressure pushes the liquids on the external auditory canal through the tube, and this is enlightening to the understanding of topical therapy with ear drops. With a randomized controlled trial, we compared two groups with and without protection when exposed to water, and found that children with OME operated with ventilation tube insertion improved their global quality of life. This improvement is significant, irrespective of the season of surgery, water activities frequency, or gender. It is also significant whether water protection is prescribed or not, and both groups (with and without protection) improved quality of life significantly after surgery, and with no observed statistical difference, meaning no impact from protection cares. Also, from this randomized controlled trial, we did not observe a difference in the prevalence of otorrhea after myringotomy with tubes for otitis media with effusion when prescribing or not water protection. And otorrhea incidence shows no apparent association with water exposure in our study population, but it does so with upper respiratory tract infection. These results support the recent guidelines from the American Academy of Otorhinolaryngology, which discourages the routine use of water protections in children with tympanostomy tubes.Paço, JoãoVoegels, RichardCruz, Paulo VeraRUNSubtil, João Eduardo Castro Campos Brito2021-07-25T00:30:32Z2019-01-182019-02-142019-01-18T00:00:00Zdoctoral thesisinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://hdl.handle.net/10362/60499TID:101489269enginfo:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2024-05-22T17:37:12Zoai:run.unl.pt:10362/60499Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T17:08:14.255714Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
title Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
spellingShingle Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
Subtil, João Eduardo Castro Campos Brito
Ear Protective Devices
Middle Ear Ventilation
Otitis Media with Effusion
Myringotomy
Postoperative Care
Quality of Life
Swimming
Computerized Fluid Dynamics.
Ciências Médicas
title_short Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
title_full Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
title_fullStr Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
title_full_unstemmed Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
title_sort Postoperative cares after tympanostomy tubes for chronic otitis media with effusion
author Subtil, João Eduardo Castro Campos Brito
author_facet Subtil, João Eduardo Castro Campos Brito
author_role author
dc.contributor.none.fl_str_mv Paço, João
Voegels, Richard
Cruz, Paulo Vera
RUN
dc.contributor.author.fl_str_mv Subtil, João Eduardo Castro Campos Brito
dc.subject.por.fl_str_mv Ear Protective Devices
Middle Ear Ventilation
Otitis Media with Effusion
Myringotomy
Postoperative Care
Quality of Life
Swimming
Computerized Fluid Dynamics.
Ciências Médicas
topic Ear Protective Devices
Middle Ear Ventilation
Otitis Media with Effusion
Myringotomy
Postoperative Care
Quality of Life
Swimming
Computerized Fluid Dynamics.
Ciências Médicas
description A pedido do Autor o conteúdo publicado em revistas com reserva de direitos
publishDate 2019
dc.date.none.fl_str_mv 2019-01-18
2019-02-14
2019-01-18T00:00:00Z
2021-07-25T00:30:32Z
dc.type.driver.fl_str_mv doctoral thesis
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/60499
TID:101489269
url http://hdl.handle.net/10362/60499
identifier_str_mv TID:101489269
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
_version_ 1833596461301891072

Similar Items