Biofilm distribution on tympanostomy tubes: An ex vivo descriptive study

Nadeem Habashi, Tal Marom, Doron Steinberg, Batya Zacks, Sharon Ovnat Tamir

    Research output: Contribution to journalArticlepeer-review

    3 Scopus citations

    Abstract

    Background: Tympanostomy tube (TT) insertion is a common procedure in children with otitis media with effusion. Post-TT otorrhea (PTTO) is a frequent post-operative complication. Biofilms are involved in chronic PTTO cases. Objective: To describe and qualitatively analyze the geometry and sites prone to biofilms on removed TTs, relatively to their position in the ear, past medical/surgical history and PTTO presence. Methods: Biofilms presence and topographic distribution on TTs were ex vivo evaluated by using scanning electron microscope, confocal microscope and stereo-microscope. Results: Forty-eight TTs from 30 children were analyzed. Indications for removal were: 71% due to retained TTs (average time from insertion: 24.4 ± 15.1 months), 23% due to chronic PTTO, and 6% due to TT obstruction/dysfunction. Different types of bacterial biofilms were detected on all TTs, regardless the time from their insertion nor their types. Biofilms were observed more on the perpendicular junction and on the internal lumen, and more biofilm colonies were detected on the medial part, facing the middle ear mucosa. TTs removed from children with PTTO exhibited more biofilm colonies when compared to their peers. Of the 16 children who underwent adenoidectomy concomitantly with TT insertion, 10 (62%) children were sent for TT removal due to retained TTs, and 6 (38%) children due to chronic PTTO (p = 0.03). Conclusion: Descriptive analysis of biofilm topographic distribution demonstrated adhesions on specific TT areas: perpendicular junctions and the internal lumen. Such “prone zones” may be the future target areas for changes in TT geometry or can be specifically coated with anti-biofilm materials.

    Original languageEnglish
    Article number110350
    JournalInternational Journal of Pediatric Otorhinolaryngology
    Volume138
    DOIs
    StatePublished - 1 Nov 2020

    Keywords

    • Biofilm
    • Complication
    • Geometry
    • Middle ear
    • Otorrhea
    • Tympanostomy tube

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Otorhinolaryngology

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