title: Use of ambulatory anesthesia with manually assisted ventilation for tympanic membrane regeneration therapy in children.
abstract: OBJECTIVE
  To present the utility of ambulatory anesthesia using manually assisted ventilation via a facemask for tympanic membrane (TM) regeneration therapy in children.
  
  
  METHODS
  The study included 10 children (age 4-11years) in whom the duration of perforation before treatment exceeded 6months and who were followed for at least 1year after treatment between December 2009 and December 2012. Under ambulatory anesthesia using manually assisted ventilation via a facemask, TM regenerative therapy with atelocollagen combined with basic fibroblast growth factor was performed in children who could not tolerate the procedure under local anesthesia alone.
  
  
  RESULTS
  All of the children completed the TM regenerative therapy under ambulatory anesthesia in less than 5min. Complete closure was achieved in nine (81.8%) ears after 1year of postoperative follow-up.
  
  
  CONCLUSIONS
  TM regenerative therapy can be performed under local anesthesia in less than 5min without a skin incision. However, local anesthesia is often insufficient in small children undergoing this procedure. Therefore, ambulatory anesthesia using manually assisted ventilation via a facemask is appropriate to complete this procedure safely in small children.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Ehime University School of Medicine, Shizugawa-cho, Toon-city, Ehime, Japan. Electronic address: hakuba@m.ehime-u.ac.jp.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hakuba
authors.affiliation: Department of Anesthesiology & Resuscitolog, Ehime University School of Medicine, Shizugawa-cho, Toon-city, Ehime, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Ikemune
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Ehime University School of Medicine, Shizugawa-cho, Toon-city, Ehime, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Ehime University School of Medicine, Shizugawa-cho, Toon-city, Ehime, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Hato
mesh_terms: D000553:Ambulatory Care / Q000379:methods; D000758:Anesthesia / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005346:Fibroblast Growth Factors / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D017214:Laryngeal Masks; D008297:Male; D044968:Regenerative Medicine / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000175:diagnosis / Q000628:therapy*
chemical_list: D005346:Fibroblast Growth Factors; D003094:Collagen