Water through the tympanostomy tube: Preliminary study using a computational fluid dynamics multiphase model
DOI:
https://doi.org/10.34631/sporl.682Keywords:
myringotomy, tympanostomy tubes, water, postoperative careAbstract
Objectives: Myringotomy with tubes is the most common otologic surgery, and most surgeons prescribe water exposure precautions after surgery. The dynamics of air and water inside the external auditory canal and the transtympanic tube during submersion is analysed and preliminary results are presented.
Study Design: Multiphase Computational Fluid Dynamics Model (CFD)
Material and methods: A computerized tomography was the base of the outer and middle ear geometry. The multiphase air-water model of Computational Fluid dynamics (CFD) model was then used in the study the inflow of water, and the escape of air through the auditory tube.
Results: The multiphase CFD model effectively describes the progression of the fluid front in the external auditory canal, the behaviour of the retained air and the air release through the auditory tube. The model also predicts under which conditions water crosses the tube to the middle ear.
Conclusions: The model confirms previously published results and can be considered adequate to study the behaviour of air and water retained in the external and middle ear.
References
Rosenfeld RM, Schwartz SR, Pynnonen MA, Tunkel DE, et al. Clinical practice guideline: Tympanostomy tubes in children. Otolaryngol Head Neck Surg. 2013 Jul;149(1 Suppl):S1-35.
Browning GG, Rovers MM, Williamson I, Lous J, Burton MJ. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2010 Oct 6;(10):CD001801
Rosenfeld RM, Bhaya MH, Bower CM, Brookhouser PE, et al. Impact of tympanostomy tubes on child quality of life. Arch Otolaryngol Head Neck Surg. 2000 May;126(5):585-92.
Grindler DJ, Blank SJ, Schulz KA, Witsell DL, et al. Impact of Otitis Media Severity on Children's Quality of Life. Otolaryngol Head Neck Surg. 2014 Aug;151(2):333-40.
Poss JM, Boseley ME, Crawford JV. Pacific Northwest survey: posttympanostomy tube water precautions. Arch Otolaryngol Head Neck Surg. 2008 Feb;134(2):133-5.
Giannoni C. Swimming with tympanostomy tubes. Arch Otolaryngol Head Neck Surg. 2000 Dec;126(12):1507-8
Goldstein NA, Mandel EM, Kurs-Lasky M, Rockette HE, Casselbrant ML. Water precautions and tympanostomy tubes: a randomized, controlled trial. Laryngoscope. 2005 Feb;115(2):324-30.
Salata JA, Derkay CS. Water precautions in children with tympanostomy tubes. Arch Otolaryngol Head Neck Surg. 1996 Mar;122(3):276-80.
Wilcox LJ, Darrow DH. Should water precautions be recommended for children with tympanostomy tubes? Laryngoscope. 2014 Jan;124(1):10-1.
Moualed D1, Masterson L, Kumar S, Donnelly N. Water precautions for prevention of infection in children with ventilation tubes (grommets). Cochrane Database Syst Rev. 2016 Jan 27;(1):CD010375.
Hebert RL 2nd, King GE, Bent JP 3rd. Tympanostomy tubes and water exposure: a practical model. Arch Otolaryngol Head Neck Surg. 1998 Oct;124(10):1118-21.
Pashley NR, Scholl PD. Tympanostomy tubes and liquids--an in vitro study. J Otolaryngol. 1984 Oct;13(5):296-8.
Smith LP, Smullen JL, Younis RT. Differential penetration of ototopicals and water through tympanostomy tubes. Laryngoscope. 2005 Aug;115(8):1367-70.
Saffer M, Miura MS. Tympanostomy tubes and water J Pediatr (Rio J). 2002 Nov-Dec;78(6):475-80.
Ma B, Ruwet V, Corieri P, Theunissen R, et al. CFD Simulation and Experimental Validation of Fluid Flow and Particle Transport in a Model of Alveolated Airways. J Aerosol Sci. 2009 May;40(5):403-141.
Van Ertbruggen C., Corieri P., Theunissen R., Riethmuller M.L., et al. Validation of CFD Predictions of Flow in a 3D Alveolated Bend with Experimental Data J Biomech. J Biomech. 2008;41(2):399-405
Geng Tian, Michael Hindle, Sau Lee, P. Worth Longest; Validating CFD Predictions of Pharmaceutical Aerosol Deposition with In Vivo Data; Pharm Res. Author manuscript; available in PMC 2016 Oct 1.
Bunne M, Falk B, Hellström S, Magnuson B. Variability of Eustachian tube function in children with secretory otitis media. Evaluations at tube insertion and at follow-up. Int J Pediatr Otorhinolaryngol. 2000 Apr 15;52(2):131-41.
Bylander A, Tjernström O, Ivarsson A. Pressure opening and closing functions of the eustachian tube in children and adults with normal ears. Acta Otolaryngol. 1983 Jan-Feb;95(1-2):55-62.
Çengel, Y. A., Cimbala, J. M.. Fluid Mechanics-Fundamentals and Applications (Third Edition ed.) Boston, McGraw-HillHigher Education 2014
Parker GS, Tami TA, Maddox MR, Wilson JF. The effect of water exposure after tympanostomy tube insertion. Am J Otolaryngol. 1994 May-Jun;15(3):193-6.
Carbonell R, Ruíz-García V. Ventilation tubes after surgery for otitis media with effusion or acute otitis media and swimming. Systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2002 Dec 2;66(3):281-9.
Wang MC, Liu CY, Shiao AS. Water penetration into middle ear through ventilation tubes in children while swimming. J Chin Med Assoc. 2009 Feb;72(2):72-5.
Subtil J, Jardim A, Peralta-Santos A, Araújo J, Saraiva J, Paco J. Water protection after tympanostomy (Shepard) tubes does not decrease otorrhea incidence - retrospective cohort study. Braz J Otorhinolaryngol. Ref. No.: BJORL-D-17-00203R1 (no prelo)
