Tympanostomy Tube Extrusion Time & Viscosity
Condition: OTITIS MEDIA WITH EFFUSION
MeSH terms: Otitis; Otitis Media; Otitis Media with Effusion
Study type: Observational [Patient Registry]

Summary: 
      Studies have focused on the factors that influence tympanostomy tube (TT) extrusion may
      contribute to the management of OME. In this study the investigators aimed to assess the
      correlation between the TT extrusion time and viscosity of the middle ear fluid. 33 patients
      scheduled for TT insertion included in the study. During the paracentesis, fluid from the
      middle ear was obtained, and the viscosity was measured with a viscometer. After the surgery,
      patients were controlled monthly until the tubes were seen extruded.The analysis of the
      correlation between tube extrusion time and viscosity was insignificant (p >0.05).
    

Detailed description: 
      45 patients were evaluated in the outpatient clinic of the Bezmialem Vakif University
      Department of Otorhinolaryngology. OME was diagnosed by endoscopic-otoscopic examination
      findings and type-B tympanograms. Patients who do not have a previous history of TT insertion
      and retraction pocket included in the study. They were all scheduled for Shepard TT
      insertion. 12 patients were excluded for not coming to their postoperative controls properly.
      Total of 33 patients' data were analyzed in the end. During the paracentesis, myringotomy
      incision was done at the anteroinferior quadrant. Fluid from the middle ear was obtained by
      using 22 gauge syringe, and the viscosity was measured with a viscometer. Since the viscosity
      in most patients was mucoid in appearance, the patients were subdivided into two groups
      according to median viscosity level to determine whether higher or lower viscosity of the
      effusion impacted tympanostomy tube extrusion time. Patients with an effusion below and above
      the median viscosity value of 439 centipoise (cP) were assigned to Group 1 and 2,
      respectively. After the surgery, patients were controlled monthly until the tubes were seen
      extruded.Brookfield DV-II+ProCP Viscometer (Brookfield Engineering Laboratories, Inc.,
      Massachusetts, USA) was used for viscosity measurements. This viscometer was able to measure
      the viscosity of fluid samples as small as 0.5 ml. The results of the viscosity measurements
      were recorded as cP units. The patients were investigated for any correlation between the
      viscosity level of the effusion and extrusion time of the TT. Descriptive statistics were
      presented as mean and standard deviation. T-test was used to estimate the correlation between
      the parameters. Mann-Whitney U Test was used to compare the two groups. Statistical analyses
      were conducted with the IBM SSPS 22.0 program. Significance level was set at 0.05 for all
      tests. All the procedures were approved and performed in accordance with the ethical
      standards of the relevant national and institutional guidelines on human experimentation and
      with the Helsinki Declaration of 1975, as revised in 2008. Permission for the study was
      obtained from Institutional Ethics Committee.
    

Intervention name(s): Middle ear fluid viscosity; Tympanostomy tube extrusion time
Intervention type(s): Other; Other
Intervention description(s): The patients were subdivided into two groups according to median viscosity level; Tympanostomy tube extrusion time of the all patients recorded prospectively.
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        33 patients who were diagnosed as otitis media with effusion and scheduled for Shepard TT
        insertion included in the study.
      
Keywords: Otitis media; tympanostomy tube; viscosity; middle ear fluid