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Pediatric ENT Procedures

Pediatric ENT Procedures

Medtronic offers innovative pediatric ENT instruments for numerous pediatric ENT procedures, including tonsillectomies, adenoidectomies, otitis media, and treating recurrent respiratory papillomatosis.

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Summary

About Pediatric ENT Procedures

At Medtronic, we recognize that pediatric ENT patients have unique needs. With dedicated resources and a passion for innovation, we develop pediatric-specific tools and techniques to facilitate better outcomes in pediatric ENT procedures. Some of our innovative pediatric ENT products include 2.0 and 2.9 mm blades and burs for pediatric sinus and airway procedures, high-speed curved burs for pediatric otologic surgery, and antimicrobial ventilation tubes.

Our pediatric ENT instruments are designed for an array of procedures and conditions.

Powered Intracapsular Tonsillectomies and Adenoidectomies (PITA)

Pediatric ENT Surgery with the PITA Technique

The PITA technique leaves the tonsillar capsule intact

For obstructive sleep apnea, our PITA™ Blades and Straightshot® M4 Microdebrider can help you remove tonsils and adenoids with precision. Studies show:

  • Most patients recover faster with fewer complications from the PITA method1-3
  • Patients returned to normal activity in 2.1 days after a PITA procedure1
  • Delayed hemorrhage was reduced from 3.4% to 1.1% with PITA method2
  • Hospital treatment for pain or dehydration decreased from 5.4% to 3.0% with PITA technique2

Recurrent Respiratory Papillomatosis (RRP)

Skimmer Blade Removing Papilloma

Skimmer Blade removing papilloma

Recurrent respiratory papillomatosis (RRP) is a rare disease caused by the very common human papilloma virus (HPV). Characterized by rapid growth of wartlike tumors in the respiratory tract, RRP is difficult to treat because of its tendency to recur and spread throughout the respiratory tract.

Our Skimmer® Laryngeal Blade for the Straightshot M4 Microdebrider allows you to gently “shave” multiple papilloma tumors that obstruct the airway. Many pediatric ENT surgeons prefer the Skimmer Blade over traditional carbon dioxide laser methods. The Skimmer Blade offers:

  • Safe, fast, precise, and less costly removal of airway lesions
  • Quicker patient recovery
  • Elimination of thermal burn and other risks of laser techniques

In a study conducted at a tertiary care children’s hospital, El-Bitar and ZalZal4 compared the use of a Skimmer Blade with that of the carbon dioxide laser in the treatment of RRP in dozens of children. The parents of pediatric patients who received treatment with the Skimmer Blade reported that the operating time was shorter, their children were more comfortable postoperatively, and could speak more clearly and sooner following surgery. Holler et al also found that the microdebrider treatment resulted in better immediate postoperative voice quality and that increased exposure to CO2 laser was associated with worsening voice quality.5

Powered Inferior Turbinoplasty

Inferior turbinate hypertrophy is a common cause of chronic nasal obstruction, which can contribute to sinusitis and obstructive sleep apnea. To overcome the disadvantages of traditional techniques and radiofrequency, Medtronic offers the innovative 2.0 mm Inferior Turbinate Blade for your pediatric ENT patients. The Inferior Turbinate Blade features a patented, elevated, rotating tip that allows you to remove tissue more precisely than traditional surgery tools, which helps protect the delicate nasal mucosa. Numerous studies in adults show that powered inferior turbinoplasty with our Inferior Turbinate Blade and Straightshot M4 Microdebrider offers significantly better long-term results than radiofrequency turbinoplasty.6-9

Choanal Atresia

We offer 2.9 mm pediatric blades and burs specifically for choanal atresia. Used with our Straightshot M4 Microdebrider, the benefits of our choanal atresia blades and burs include:

  • Allows for progressive reduction
  • Tapered irrigated bur facilitates smooth, regular borders
  • Enables better access in tight spaces

Cochleostomies

To facilitiate cochlear implantation, we offer High-Speed Curved Burs for our Midas Rex® Legend® EHS Stylus High-Speed Surgical Drill and Visao® High-Speed Otologic Drill . Benefits of our curved burs for pediatric cochleostomies include:

  • Visibility and access in deep, narrow spaces
  • Delicate bone and tissue removal
  • Extended outer bur sheath

Additionally, our intraoperative NIM® Nerve Monitoring Systems enable surgeons to identify and confirm motor nerve function and monitor major motor nerves during cochlear implantation procedures, as well as other surgical procedures. The NIM Systems may provide visual and audible warnings if there is a change in nerve function, helping reduce the risk of nerve damage during surgery. Surgeons can monitor up to 8 channels of nerve-muscle combinations using our innovative NIM-Neuro® system.

Chronic Otitis Media

We offer a broad assortment of tympanostomy tubes to suit a variety of pediatric ENT patients. Our innovative Activent® and Microgel™ tubes help inhibit bacterial growth or adherence.

Activent Antimicrobial Ventilation Tubes

Activent tubes have a proven bacteriocidal/bacteriostatic effect, inhibiting the growth of bacteria that can contribute to secondary infections and postoperative otorrhea.10 Clinical data show a significant reduction in the incidence of postoperative otorrhea in ears implanted with Activent tubes compared with conventional tubes.10,11 And in vitro tests show a clear zone of bacterial inhibition around the Activent tube.12 Activent antimicrobial ventilation tubes are available in a variety of styles for your pediatric ENT patients.

Microgel Surface-Enhanced Silicone Vent Tubes

Microgel tubes have a patented hydrogel coating that increases the surface energy of silicone, reducing the attachment of microbial pathogens.13 In fact, Microgel surface enhancement reduces the occurrence of bacterial adherence by more than 90%.

Tympanic Membrane Patching

For perforated tympanic membranes, we offer the innovative Tympanic Membrane Patcher as an alternative to surgery. The TM Patcher is well-suited for pediatric ENT patients who have immature eustachian tube dysfunction, as well as patients with a perforation in an only-hearing ear, elderly patients, or the very ill. With thin, 0.13 mm pliable flanges, the TM Patcher provides flexibility to fold the deep flange into the perforation, while allowing enough rigidity for the lateral flanges to remain in place. Its soft, green silicone aids in recognition and placement, and is both easily trimmable and removable in the office.

Additional Product Information

View the ENT Product Catalog for more information about our pediatric ENT instruments.

 


References

1

Bitar MA, Rameh C. Microdebrider-assisted partial tonsillectomy: short- and long-term outcomes. Eur Arch Otorhinolaryngol 2008;265(4):459-463.

2

Schmidt R, Herzog A, Cook S, O’Reilly R, Deutsch E, Reilly J. Complications of tonsillectomy. A comparison of techniques. Arch Otolaryngol Head Neck Surg 2007;133:925-8.

3

Derkay CS, Darrow DH, Welch C, Sinacori J. Post-tonsillectomy morbidity and quality of life in pediatric patients with obstructive tonsils and adenoid: microdebrider vs electrocautery. Otolaryngol Head Neck Surg 2006; Jan; 134(1):114-20.

4

El-Bitar MA, Zalzal GH. Powered instrumentation in the treatment of recurrent respiratory papillomatosis: an alternative to the carbon dioxide laser. Arch Otolaryngol Head Neck Surg 2002;128:425-8.

5

Holler T, Allegro J, Chadha NK et al. Voice outcomes following repeated surgical resection of laryngeal papillomata in children. Otolaryngol Head Neck Surgery 2009; 141: 522-526.

6

Liu C-M, Tan C-D, Lee F-P, Lin K-N, Huang H-M. Microdebrider-assisted versus radiofrequency-assisted inferior turbinoplasty. Laryngoscope 2009;119:414-8.

7

Berger G, Ophir D, Pitaro K, Landsberg R. Histopathological changes after Coblation® inferior turbinate reduction. Arch Otolaryngol Head Neck Surg 2008;134:819-23.

8

Lee JY, Lee JD. Comparative study on the long-term effectiveness between Coblation- and microdebrider-assisted partial turbinoplasty. Laryngoscope 2006;116:729-34.

9

Atef A, Mosleh M, El Bosraty H, El Fatah GA, Fathi A. Bipolar radiofrequency volumetric tissue reduction of inferior turbinate: Does the number of treatment sessions influence the final outcome? Am J Rhinol 2006; 20: 25-31.

10

Chole RA, Hubbell RN. Antimicrobial activity of silastic tympanostomy tubes impregnated with silver oxide: a double-blind randomized multicenter trial. Arch Otolaryngol Head Neck Surg 1995; 121: 562-565.

11

Gourin, CG, MD, Hubbell, RN, MD. Otorrhea after insertion of silver oxide-impregnated silastic tympanostomy tubes. Arch Otolaryngol Head Neck Surg 1999; 125: 446-450.

12

Independent laboratory results on file with Medtronic ENT.

13

Dunkirk SG, Gregg ST, Duran LW, Monfils JD, Haapala JE, Marcy JA, Clapper DL, Amos RA, Guire PE. Photochemical coatings for the prevention of bacterial colonization. J Biomater Appl 1991; 6:131-156