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Lawrence Z Meiteles - One of the best experts on this subject based on the ideXlab platform.
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eustachian tube endoscopy in patients with chronic ear disease
Laryngoscope, 2000Co-Authors: Christopher J Linstrom, Arie Rosen, Carol A. Silverman, Lawrence Z MeitelesAbstract:Objectives/Hypothesis A paucity of research exists on trans–eustachian tube endoscopy to evaluate the status of the eustachian tube. Fuller examination of the role of the eustachian tube in chronic ear disease is needed, particularly because the eustachian tube has been implicated in the chronicity and pathogenesis of chronic ear disease. Therefore the purpose of this study was to evaluate the eustachian tube, based on observations from trans–eustachian tube endoscopy. Study Design Twenty-two adult patients with chronic ear disease gave informed consent to participate in a prospective, trans–eustachian tube endoscopic investigation. Methods Flexible, fiberoptic, nonarticulating (outside diameter of 0.5 mm) and articulating (outside diameter of 1.0 mm) Endoscopes (coherent fused bundle of 3,000 pixels) were employed. The eustachian tube endoscopy was performed under general endotracheal anesthesia as the initial part of a larger, otological surgical procedure for chronic ear disease. The Endoscope was passed from the middle ear (transtympanic approach) to the nasopharynx. Results The 0.5-mm Endoscope passed entirely through the eustachian tube from the tympanic orifice into the pharyngeal orifice in 16% of the cases. Stenotic blockage occurred at the infundibulum in 37%, isthmus in 42%, and fossa of Rosenmuller in 5% of cases. The eustachian tube mucosa was abnormal in 64% of cases. The risk for abnormal eustachian tube mucosa was four times greater for persons with long-standing disease (≥20 y) than for persons without long-standing disease (<20 y). The mean therapeutic efficiency of ossicular reconstruction was higher for the subgroup with normal than for the subgroup with abnormal eustachian tube mucosa. Conclusions The findings of trans–eustachian tube endoscopy provide objective evidence concerning eustachian tube status in persons with chronic ear disease and have implications for the timing of surgical intervention (ossicular reconstruction).
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Eustachian tube endoscopy in patients with chronic ear disease.
Laryngoscope, 2000Co-Authors: Christopher J Linstrom, Arie Rosen, Carol A. Silverman, Lawrence Z MeitelesAbstract:Objectives/Hypothesis A paucity of research exists on trans–eustachian tube endoscopy to evaluate the status of the eustachian tube. Fuller examination of the role of the eustachian tube in chronic ear disease is needed, particularly because the eustachian tube has been implicated in the chronicity and pathogenesis of chronic ear disease. Therefore the purpose of this study was to evaluate the eustachian tube, based on observations from trans–eustachian tube endoscopy. Study Design Twenty-two adult patients with chronic ear disease gave informed consent to participate in a prospective, trans–eustachian tube endoscopic investigation. Methods Flexible, fiberoptic, nonarticulating (outside diameter of 0.5 mm) and articulating (outside diameter of 1.0 mm) Endoscopes (coherent fused bundle of 3,000 pixels) were employed. The eustachian tube endoscopy was performed under general endotracheal anesthesia as the initial part of a larger, otological surgical procedure for chronic ear disease. The Endoscope was passed from the middle ear (transtympanic approach) to the nasopharynx. Results The 0.5-mm Endoscope passed entirely through the eustachian tube from the tympanic orifice into the pharyngeal orifice in 16% of the cases. Stenotic blockage occurred at the infundibulum in 37%, isthmus in 42%, and fossa of Rosenmuller in 5% of cases. The eustachian tube mucosa was abnormal in 64% of cases. The risk for abnormal eustachian tube mucosa was four times greater for persons with long-standing disease (≥20 y) than for persons without long-standing disease (
Christopher J Linstrom - One of the best experts on this subject based on the ideXlab platform.
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eustachian tube endoscopy in patients with chronic ear disease
Laryngoscope, 2000Co-Authors: Christopher J Linstrom, Arie Rosen, Carol A. Silverman, Lawrence Z MeitelesAbstract:Objectives/Hypothesis A paucity of research exists on trans–eustachian tube endoscopy to evaluate the status of the eustachian tube. Fuller examination of the role of the eustachian tube in chronic ear disease is needed, particularly because the eustachian tube has been implicated in the chronicity and pathogenesis of chronic ear disease. Therefore the purpose of this study was to evaluate the eustachian tube, based on observations from trans–eustachian tube endoscopy. Study Design Twenty-two adult patients with chronic ear disease gave informed consent to participate in a prospective, trans–eustachian tube endoscopic investigation. Methods Flexible, fiberoptic, nonarticulating (outside diameter of 0.5 mm) and articulating (outside diameter of 1.0 mm) Endoscopes (coherent fused bundle of 3,000 pixels) were employed. The eustachian tube endoscopy was performed under general endotracheal anesthesia as the initial part of a larger, otological surgical procedure for chronic ear disease. The Endoscope was passed from the middle ear (transtympanic approach) to the nasopharynx. Results The 0.5-mm Endoscope passed entirely through the eustachian tube from the tympanic orifice into the pharyngeal orifice in 16% of the cases. Stenotic blockage occurred at the infundibulum in 37%, isthmus in 42%, and fossa of Rosenmuller in 5% of cases. The eustachian tube mucosa was abnormal in 64% of cases. The risk for abnormal eustachian tube mucosa was four times greater for persons with long-standing disease (≥20 y) than for persons without long-standing disease (<20 y). The mean therapeutic efficiency of ossicular reconstruction was higher for the subgroup with normal than for the subgroup with abnormal eustachian tube mucosa. Conclusions The findings of trans–eustachian tube endoscopy provide objective evidence concerning eustachian tube status in persons with chronic ear disease and have implications for the timing of surgical intervention (ossicular reconstruction).
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Eustachian tube endoscopy in patients with chronic ear disease.
Laryngoscope, 2000Co-Authors: Christopher J Linstrom, Arie Rosen, Carol A. Silverman, Lawrence Z MeitelesAbstract:Objectives/Hypothesis A paucity of research exists on trans–eustachian tube endoscopy to evaluate the status of the eustachian tube. Fuller examination of the role of the eustachian tube in chronic ear disease is needed, particularly because the eustachian tube has been implicated in the chronicity and pathogenesis of chronic ear disease. Therefore the purpose of this study was to evaluate the eustachian tube, based on observations from trans–eustachian tube endoscopy. Study Design Twenty-two adult patients with chronic ear disease gave informed consent to participate in a prospective, trans–eustachian tube endoscopic investigation. Methods Flexible, fiberoptic, nonarticulating (outside diameter of 0.5 mm) and articulating (outside diameter of 1.0 mm) Endoscopes (coherent fused bundle of 3,000 pixels) were employed. The eustachian tube endoscopy was performed under general endotracheal anesthesia as the initial part of a larger, otological surgical procedure for chronic ear disease. The Endoscope was passed from the middle ear (transtympanic approach) to the nasopharynx. Results The 0.5-mm Endoscope passed entirely through the eustachian tube from the tympanic orifice into the pharyngeal orifice in 16% of the cases. Stenotic blockage occurred at the infundibulum in 37%, isthmus in 42%, and fossa of Rosenmuller in 5% of cases. The eustachian tube mucosa was abnormal in 64% of cases. The risk for abnormal eustachian tube mucosa was four times greater for persons with long-standing disease (≥20 y) than for persons without long-standing disease (
Subhas Banerjee - One of the best experts on this subject based on the ideXlab platform.
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simethicone is retained in Endoscopes despite reprocessing impact of its use on working channel fluid retention and adenosine triphosphate bioluminescence values with video
Gastrointestinal Endoscopy, 2019Co-Authors: Monique T. Barakat, Robert J. Huang, Subhas BanerjeeAbstract:Background and Aims Studies from our group and others demonstrate residual fluid in 42% to 95% of Endoscope working channels despite high-level disinfection and drying. Additionally, persistent simethicone has been reported in Endoscope channels despite reprocessing. Methods Endoscopy was performed by using water or varied simethicone concentrations (0.5%, 1%, 3%) for flushing. After high-level disinfection/drying, we inspected Endoscope working channels for retained fluid by using the SteriCam borescope. Working channel rinsates were evaluated for adenosine triphosphate (ATP) bioluminescence. Fourier transform infrared spectroscopy was performed on fluid droplets gathered from a colonoscope in which low-concentration simethicone was used. Results Use of medium/high concentrations of simethicone resulted in a higher mean number of fluid droplets (13.5/17.3 droplets, respectively) and ATP bioluminescence values (20.6/23 relative light units [RLUs], respectively) compared with that of procedures using only water (6.3 droplets/10.9 RLUs; P Conclusions Use of medium/high concentrations of simethicone is associated with retention of increased fluid droplets and higher ATP bioluminescence values in Endoscope working channels, compared with Endoscopes in which water or low concentration simethicone was used. However, simethicone is detectable in Endoscopes despite reprocessing, even when it is utilized in low concentrations. Our data suggest that when simethicone is used, it should be used in the lowest concentration possible. Facilities may consider 2 automated Endoscope reprocessor cycles for reprocessing of Endoscopes when simethicone has been used.
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Scoping the scope: endoscopic evaluation of Endoscope working channels with a new high-resolution inspection Endoscope (with video)
Gastrointestinal Endoscopy, 2018Co-Authors: Monique T. Barakat, Mohit Girotra, Robert J. Huang, Subhas BanerjeeAbstract:Background and Aims Outbreaks of transmission of infection related to endoscopy despite reported adherence to reprocessing guidelines warrant scrutiny of all potential contributing factors. Recent reports from ambulatory surgery centers indicated widespread significant occult damage within Endoscope working channels, raising concerns regarding the potential detrimental impact of this damage on the adequacy of Endoscope reprocessing. Methods We inspected working channels of all 68 Endoscopes at our academic institution using a novel flexible inspection Endoscope. Inspections were recorded and videos reviewed by 3 investigators to evaluate and rate channel damage and/or debris. Working channel rinsates were obtained from all Endoscopes, and adenosine triphosphate (ATP) bioluminescence was measured. Results Overall Endoscope working channel damage was rated as minimal and/or mild and was consistent with expected wear and tear (median 1.59 on our 5-point scale). Our predominant findings included superficial scratches (98.5%) and scratches with adherent peel (76.5%). No channel perforations, stains, or burns were detected. The extent of damage was not predicted by Endoscope age. Minor punctate debris was common, and a few small drops of fluid were noted in 42.6% of Endoscopes after reprocessing and drying. The presence of residual fluid predicted higher ATP bioluminescence values. The presence of visualized working channel damage or debris was not associated with elevated ATP bioluminescence values. Conclusion The flexible inspection Endoscope enables high-resolution imaging of Endoscope working channels and offers endoscopy units an additional modality for Endoscope surveillance, potentially complementing bacterial cultures and ATP values. Our study, conducted in a busy academic endoscopy unit, indicated predominately mild damage to Endoscope working channels, which did not correlate with elevated ATP values.
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adenosine triphosphate bioluminescence for bacteriologic surveillance and reprocessing strategies for minimizing risk of infection transmission by duodenoscopes
Gastrointestinal Endoscopy, 2017Co-Authors: Saurabh Sethi, Monique T. Barakat, Robert J. Huang, Niaz Banaei, Shai Friedland, Subhas BanerjeeAbstract:Background and Aims Recent outbreaks of duodenoscope-transmitted infections underscore the importance of adequate Endoscope reprocessing. Adenosine triphosphate (ATP) bioluminescence testing allows rapid evaluation of Endoscopes for bacteriologic/biologic residue. In this prospective study we evaluate the utility of ATP in bacteriologic surveillance and the effects of endoscopy staff education and dual cycles of cleaning and high-level disinfection (HLD) on Endoscope reprocessing. Methods ATP bioluminescence was measured after precleaning, manual cleaning, and HLD on rinsates from suction-biopsy channels of all Endoscopes and elevator channels of duodenoscopes/linear echoEndoscopes after use. ATP bioluminescence was remeasured in duodenoscopes (1) after re-education and competency testing of endoscopy staff and subsequently (2) after 2 cycles of precleaning and manual cleaning and single cycle of HLD or (3) after 2 cycles of precleaning, manual cleaning, and HLD. Results The ideal ATP bioluminescence benchmark of P P Conclusions ATP testing offers a rapid, inexpensive alternative for detection of Endoscope microbial residue. Re-education of endoscopy staff and 2 cycles of cleaning and HLD decreased elevator channel RLUs to levels similar to sterile water and may therefore minimize the risk of transmission of infections by duodenoscopes.
Hisashi Doyama - One of the best experts on this subject based on the ideXlab platform.
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Current status of transnasal endoscopy using ultrathin videoscope for upper GI tract in the world
Digestive Endoscopy, 2016Co-Authors: Tokuma Tanuma, Yoshinori Morita, Hisashi DoyamaAbstract:Transnasal endoscopy with an ultrathin Endoscope has been reported to be highly acceptable even without any sedative measures. Poor image quality and complex manipulation have been reported as shortcomings of this type of endoscopy compared with standard transoral endoscopy. However, image quality has improved markedly with the latest ultrathin Endoscopes. To investigate the status of clinical use of Endoscopes, we recently conducted a questionnaire survey involving 149 facilities (98 in Japan and 51 overseas). In Japan, transnasal Endoscopes were being used primarily in clinics (34% in clinics and 9% in hospitals). Overseas, however, transnasal Endoscopes were seldom used (1% in hospitals and 0% in clinics). This may be attributable to the complex pretreatment and more challenging manipulation required for transnasal Endoscopes. However, it is evident that transnasal Endoscopes are highly acceptable for patients. If the pretreatment required is simplified and healthcare physicians improve their skills and understanding, this type of endoscopy will have high potential for common use.
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current status of transnasal endoscopy worldwide using ultrathin videoscope for upper gastrointestinal tract
Digestive Endoscopy, 2016Co-Authors: Tokuma Tanuma, Yoshinori Morita, Hisashi DoyamaAbstract:Transnasal endoscopy with an ultrathin Endoscope has been reported to be highly acceptable even without any sedative measures. Poor image quality and complex manipulation have been reported as shortcomings of this type of endoscopy compared with standard transoral endoscopy. However, image quality has improved markedly with the latest ultrathin Endoscopes. To investigate the status of clinical use of Endoscopes, we recently conducted a questionnaire survey involving 149 facilities (98 in Japan and 51 overseas). In Japan, transnasal Endoscopes were being used primarily in clinics (34% in clinics and 9% in hospitals). Overseas, however, transnasal Endoscopes were seldom used (1% in hospitals and 0% in clinics). This may be attributable to the complex pretreatment and more challenging manipulation required for transnasal Endoscopes. However, it is evident that transnasal Endoscopes are highly acceptable for patients. If the pretreatment required is simplified and healthcare physicians improve their skills and understanding, this type of endoscopy will have high potential for common use.
Carol A. Silverman - One of the best experts on this subject based on the ideXlab platform.
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eustachian tube endoscopy in patients with chronic ear disease
Laryngoscope, 2000Co-Authors: Christopher J Linstrom, Arie Rosen, Carol A. Silverman, Lawrence Z MeitelesAbstract:Objectives/Hypothesis A paucity of research exists on trans–eustachian tube endoscopy to evaluate the status of the eustachian tube. Fuller examination of the role of the eustachian tube in chronic ear disease is needed, particularly because the eustachian tube has been implicated in the chronicity and pathogenesis of chronic ear disease. Therefore the purpose of this study was to evaluate the eustachian tube, based on observations from trans–eustachian tube endoscopy. Study Design Twenty-two adult patients with chronic ear disease gave informed consent to participate in a prospective, trans–eustachian tube endoscopic investigation. Methods Flexible, fiberoptic, nonarticulating (outside diameter of 0.5 mm) and articulating (outside diameter of 1.0 mm) Endoscopes (coherent fused bundle of 3,000 pixels) were employed. The eustachian tube endoscopy was performed under general endotracheal anesthesia as the initial part of a larger, otological surgical procedure for chronic ear disease. The Endoscope was passed from the middle ear (transtympanic approach) to the nasopharynx. Results The 0.5-mm Endoscope passed entirely through the eustachian tube from the tympanic orifice into the pharyngeal orifice in 16% of the cases. Stenotic blockage occurred at the infundibulum in 37%, isthmus in 42%, and fossa of Rosenmuller in 5% of cases. The eustachian tube mucosa was abnormal in 64% of cases. The risk for abnormal eustachian tube mucosa was four times greater for persons with long-standing disease (≥20 y) than for persons without long-standing disease (<20 y). The mean therapeutic efficiency of ossicular reconstruction was higher for the subgroup with normal than for the subgroup with abnormal eustachian tube mucosa. Conclusions The findings of trans–eustachian tube endoscopy provide objective evidence concerning eustachian tube status in persons with chronic ear disease and have implications for the timing of surgical intervention (ossicular reconstruction).
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Eustachian tube endoscopy in patients with chronic ear disease.
Laryngoscope, 2000Co-Authors: Christopher J Linstrom, Arie Rosen, Carol A. Silverman, Lawrence Z MeitelesAbstract:Objectives/Hypothesis A paucity of research exists on trans–eustachian tube endoscopy to evaluate the status of the eustachian tube. Fuller examination of the role of the eustachian tube in chronic ear disease is needed, particularly because the eustachian tube has been implicated in the chronicity and pathogenesis of chronic ear disease. Therefore the purpose of this study was to evaluate the eustachian tube, based on observations from trans–eustachian tube endoscopy. Study Design Twenty-two adult patients with chronic ear disease gave informed consent to participate in a prospective, trans–eustachian tube endoscopic investigation. Methods Flexible, fiberoptic, nonarticulating (outside diameter of 0.5 mm) and articulating (outside diameter of 1.0 mm) Endoscopes (coherent fused bundle of 3,000 pixels) were employed. The eustachian tube endoscopy was performed under general endotracheal anesthesia as the initial part of a larger, otological surgical procedure for chronic ear disease. The Endoscope was passed from the middle ear (transtympanic approach) to the nasopharynx. Results The 0.5-mm Endoscope passed entirely through the eustachian tube from the tympanic orifice into the pharyngeal orifice in 16% of the cases. Stenotic blockage occurred at the infundibulum in 37%, isthmus in 42%, and fossa of Rosenmuller in 5% of cases. The eustachian tube mucosa was abnormal in 64% of cases. The risk for abnormal eustachian tube mucosa was four times greater for persons with long-standing disease (≥20 y) than for persons without long-standing disease (
