In this episode of BackTable ENT, Dr. Jordan Schramm of Peak Pediatric ENT in Provo, Utah, chats with hosts Dr. Gopi Shah and Dr. Ashley Agan about in-office ear tubes for children.

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SHOW NOTES

First, Jordan describes the technology behind in-office tube placement. Jordan uses the Tula ® Tympanostomy system (available from Smith + Nephew) to insert ear tubes in-office. Tula offers an integrated tympanostomy solution that combines local anesthetic with tube insertion. With the Tula system, a gentle current numbs the tympanic membrane in 10-15 minutes, after which a pre-packaged delivery device allows the operator to insert a tube by simply placing the device on a patient’s eardrum and then clicking a button.

Next, the discussion shifts towards Jordan’s personal experience with the Tula system. Gopi, Ashley, and Jordan compare Tula tubes with conventional T-tubes. Jordan emphasizes that almost all children needing tubes are candidates, though normal ear anatomy and motivated parents make the procedure easier. Jordan then offers additional practical technical pearls about the Tula system.

Finally, Jordan shares how his experience with in-office ear tubes pushed the boundaries of in-office procedures. Given that ear tube placement in the OR requires general anesthesia, time off of work and facility fees are major challenges to traditional tympanostomy tube placement. For this reason, many of his families are excited to help their children hear better with an in-office procedure. He finishes with his tips for training clinic staff, working with insurance companies, and counseling families on the procedure.

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RESOURCES

Jordan’s Peak Pediatric ENT Profile:

https://utahpedsent.com/doctors.php

Tula Tube System (for Physicians):

https://tulatubes.com/physicians/tula-tympanostomy-system/

Article comparing outcomes of Tula tubes with conventional ear tubes (mentioned by Jordan):

https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.336