Gimme the Ear Tubes
In trying to sort out what to do with this blog and how it could be useful, I asked around among my friends what sort of topics could be useful.
“TUBES!!!” shouted the horde of crying, exhausted mothers.
“OK, I guess we can talk about those. What else?” I asked.
“TUBES!!!” they shouted again, even louder, and they threw their chai teas against the wall in what I can only guess is a cry for help.
“Ok, noted, but I guess—“
“TUBES!!!” they shouted. They followed me out to my car and rocked it back and forth as I started my car. A few of them were trying to stick their babies in my car as I rode away, and I had to lock my doors. The sound of thrown pacifiers clicking against my back window continued much longer than it should have. I’m pretty sure some of them were running after me.
因此，让我们谈谈“管子”。全名是“压力均衡管”（PET），这是Ent所做的最常见的程序之一。这些是什么？您什么时候需要一个？他们可以为您做什么？你现在可以把它们放入吗？这些都是我们得到的最常见问题。
A PET is basically a pipe that gets inserted across the ear drum. Most of them look like the kind of pipes that Mario sinks through to get his coins; these are called Paparellas, an appropriately Italian name. Another is called a “Goode T-tube” which we pronounce “goodie,” as in, “Oh goodie, the last patient of the day wants me to put a T-tube in right now.” The Paparellas are supposed to last about 9 months to a year, and the T-tubes can last 1-2 years. These tubes help drain fluid from the middle ear into the external ear canal, and this helps relieve pressure, prevent severe infections, and sometimes improve hearing.
你需要一只耳朵管当你有慢性耳炎media, which are fancy words for fluid behind the ear drum on either a prolonged or recurrent basis. Kids and adults have different reasons for getting ear tubes. In kids, we usually check an audiogram or hearing test to see if there is fluid behind the ear drum and if there is a “conductive hearing loss” (CHL). Conductive hearing loss means that sound energy is not being properly transferred into the inner ear, decreasing hearing. In this case, if there is CHL和there is fluid behind the ear drum, then the decision is easy. We go ahead and put the ear tubes in with kids, because we want to preserve their hearing while they are developing language. In adults though, it’s left up to a discussion between the ENT and the patient. Most of the time, I will encourage adults to try to gently “pop your ears” like you would on an airplane and try various decongestants to attempt to resolve the otitis media without making a hole in the eardrum.
Notice I didn’t say anything about a number of infections, which often blows people’s minds these days. The reason is that our academy mainly points to CHL as a firm indication for ear tubes. The frequency of ear infections as an indication is left up to the discretion of the ENT, since there’s no “magic number” of ear infections that triggers a significant increase in risk for the patient. The recommendation from the academy is to avoid ear tubes if there is no fluid behind the ear drum at the time of evaluation, because we’re trying to prevent risks of anesthesia exposure and surgery in kids.
在成年人中，我们可以将耳管穿过办公室的耳道。但是，在孩子们中，通常我们必须在OR上做一些镇静，因为孩子们会被镇定的飞镖摇摆不定。它需要不到30分钟的时间。如果醒着，当我们涂上麻木药时，耳鼓会燃烧一点，但是之后，只要您静止不动，它就可以忍受了。尽管耳膜中的孔很难预测，但风险没有太大的风险。绝大多数人自己关闭，但是有些人保持开放，需要其他程序才能关闭它们。
So those are ear tubes. *Cue noise of Mario sinking into a pipe*