title: A novel technique of otic barotrauma management using modified intravenous cannulae.
abstract: This article provides the first detailed description and systematic evaluation of the management of otic barotrauma using modified intravenous cannulae. A 24-gauge IC cannula was modified as a tool for tympanostomy tube placement and middle ear ventilation. The medical records of 271 ears of 156 adult patients (median age 49 years) who underwent this procedure were reviewed retrospectively. Hundred and ninty-one tubes were placed for otalgia because of hyperbaric oxygen therapy, 58 tubes were inserted for air travel prophylaxis and 22 tubes were placed for management of otic barotrauma post-flight. All the patients who had this procedure for prophylaxis experienced regular otic barotrauma symptoms during air travel prior to tube placement. All patients were reviewed 6 weeks (range 2-9 weeks) post-procedure. This technique of otic barotrauma management worked effectively in 99 % of treated patients. On follow-up, 88 % of tubes were found to be extruded and non-extruded tubes were removed in clinic without any anaesthesia. 99.6 % of tympanic membrane had healed completely and spontaneously without sequelae. Given the safety, effectiveness, low risk of complications associated with this novel tympanostomy technique, it provided a simple yet effective therapeutic option for the management of otic barotrauma. Finally, this technique can be easily applied in all health settings as it only requires medical supplies readily available in hospitals, therefore there is no additional cost.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Prince of Wales Hospital, Sydney, NSW 2031, Australia. zhangnsw@gmail.com
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Catherine
authors.initials: C
authors.lastname: Banks
authors.forename: Sim
authors.initials: S
authors.lastname: Choroomi
authors.forename: Thomas
authors.initials: T
authors.lastname: Kertesz
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000368:Aged; D001469:Barotrauma / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D004432:Ear, Middle / Q000293:injuries* / Q000601:surgery; D004433:Earache / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000295:instrumentation / Q000379:methods*; D010865:Pilot Projects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000293:injuries* / Q000601:surgery; D062666:Vascular Access Devices; D055815:Young Adult