Awake Ear Tube Placement In Children

Ear tubes are placed often in young children
for chronic ear infections or persistent fluid in the ears causing hearing loss. Typically, ear tubes in kids are placed under
full general anesthesia. However, a new device allows for ear tube
placement under sedation, but not general anesthesia. In highly cooperative kids, it can even be
performed fully awake without any sedation. Called the Hummingbird TTS, this device allows
for simultaneous eardrum incision and tube placement with a single pass significantly
reducing operative time and child discomfort. First, earwax is removed to allow clear visualization
of the eardrum. A topical numbing liquid is then applied to
the eardrum with a tiny sponge tipped applicator. The device is then introduced into the ear
canal and used to both incise the eardrum and insert a tube with a single pass. Historically, this single step in the procedure
would require 3 instrument passes (knife to incise the eardrum, forceps to place the tube
near the eardrum hole, and yet another instrument to push the tube into position within the
eardrum itself). Here’s an actual video of a tube placement
in an awake child. Note that the child is first wrapped in a
bedsheet to keep the hands down. The parent is present to keep the child as
calm as possible. The same steps described already is then performed: 1) Earwax removal to expose the eardrum
2) Topical numbing liquid applied with a sponge tipped applicator
3) Device insertion to both incise the eardrum and place tube with a single pass Please keep in mind that not all children
are candidates nor do many places offer this procedure.


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