title: Investigation of surface changes in different types of ventilation tubes using scanning electron microscopy and correlation of findings with clinical follow-up.
abstract: OBJECTIVE
  Like all biomaterials, ventilation tubes are subject to formation of bacterial biofilm on their surfaces. There might also be surface changes. This increases the risk of complications associated with ventilation tubes. In this study, we examined two groups of ventilation tubes using scanning electron microscopy (SEM) to investigate biofilm growth and surface deformations.
  
  
  METHODS
  There were two different types of ventilation tubes used, the first group consisted of 30 silicone tubes and the second group consisted of 16 ionized, processed silicone tubes. The tube samples included those that were either removed or those that were extruded into the ear canal. We investigated the association between scanning electron microscopy findings and the complications that developed during the treatment.
  
  
  RESULTS
  As a result of this study, it is found that the ionized, processed silicone tubes are superior to other silicon ventilation tubes in regard to biofilm growth (z=-3.925, p=0.000, <0.0001) and surface deformations (chi(2)=9.120, p=0.003, <0.01). Furthermore, we observed that as the duration of the ventilation tube application increases, bacterial biofilm growth (chi(2)=10.718, p=0.005, <0.01) and surface deformations (z=-2.940, p=0.003, <0.01) increase. We also observed that biofilm growth and occurrence frequency were related to "otorrhea" (chi(2)=10.258, p=0.036, <0.05) and "plugging" (chi(2)=7.952, p=0.019, <0.05) complications.
  
  
  CONCLUSIONS
  In this study, we show that ionized, processed silicone ventilation tubes are more robust to bacterial biofilm growth compared to other silicone ventilation tubes used in this study and that the "otorrhea" and "plugging" complications are reduced with the decrease of bacterial biofilm growth.
authors.affiliation: Hacettepe University Faculty of Medicine, Department of Otorhinolaryngology - Head and Neck Surgery, Ankara, Turkey.
authors.forename: Emel C
authors.initials: EC
authors.lastname: Tatar
authors.forename: Faruk Omer
authors.initials: FO
authors.lastname: Unal
authors.forename: Ilkan
authors.initials: I
authors.lastname: Tatar
authors.forename: Hakan Hamdi
authors.initials: HH
authors.lastname: Celik
authors.forename: Bulent
authors.initials: B
authors.lastname: Gursel
mesh_terms: D001672:Biocompatible Materials; D018441:Biofilms; D005500:Follow-Up Studies; D006801:Humans; D008855:Microscopy, Electron, Scanning / Q000295:instrumentation*; D008876:Middle Ear Ventilation / Q000295:instrumentation*; D010034:Otitis Media with Effusion / Q000601:surgery; D011446:Prospective Studies; D019736:Prostheses and Implants; D014432:Tympanic Membrane / Q000601:surgery* / Q000648:ultrastructure*
chemical_list: D001672:Biocompatible Materials