A project has been undertaken at the Massachusetts Eye and Ear Infirmary to treat a group of 50 children with chronic secretory otitis media by long-term middle ear ventilation. For the purpose of pressure equalization, a 5 mm arrow-tipped tube, designed from No. 190 polyethylene tubing (Figure), was found to be superior to other tubes currently in use.
It is short enough to prevent the outer end from becoming occluded, either by cerumen or by contact with the external auditory canal; yet it is long enough so that proper placement and positioning can easily be accomplished. Unlike longer tubes, which may hinder adequate visualization of the tympanic membrane during the course of the disease, the arrow tube allows excellent observation of the drum. Because of its large inner diameter (1 mm), the middle ear mucosa can be visualized through the lumen of the tube. The inner flange on the arrow
LINDEMAN RC, SILVERSTEIN H. Clinical Notes, New Instruments and Techniques: The "Arrow Tube". Arch Otolaryngol. 1964;80(4):473. doi:10.1001/archotol.1964.00750040485018
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