Removal of biofilm is essential for long-term ventilation tuberetention

BACKGROUND Although long-term retention of a ventilation tube is required in many ear diseases,spontaneous removal of conventional ventilation tube is observed in patients within 3 to 12 mo.To address this issue,we aimed to determine a new method for long-term retention of the ventilation tube.AIM To explore the value of removing the biofilm for long-term retention of tympanostomy ventilation tubes.METHODS A case-control study design was used to evaluate the safety and effectiveness of long-term tube retention by directly removing the biofilm(via surgical exfoliation)in patients who underwent myringotomy with ventilation tube placement.The patients were randomly divided into two groups:Control group and treatment group.Patients in the treatment group underwent regular biofilm exfoliation surgery in the clinic,whereas those in the control group did not have their biofilm removed.Only conventional ventilation tubes were placed in this study.Outcome measures were tube position and patency.Tube retention time and any complications were documented.RESULTS Eight patients with biofilm removal and eight patients without biofilm removal as a control group were enrolled in the study.The tympanostomy tube retention time was significantly longer in the treatment group(43.5±26.4 mo)than in the control group(9.5±6.9 mo)(P=0.003).More tympanostomy tubes were found to be patent and in correct position in the treatment group during the follow-up intervals than in the control group(P=0.01).CONCLUSION Despite the use of short-term ventilation tubes,direct biofilm removal can be a well-tolerated and effective treatment for long-term tube retention of tympanostomy ventilation tubes in patients who underwent myringotomy.

Multisensory Exercise Improves Balance in People with Balance Disorders: A Systematic Review

Objective To examine the effect of multisensory exercise on balance disorders.Methods PubMed,Scopus and Web of Science were searched to identify eligible studies published before January 1,2020.Eligible studies included randomized control trials(RCTs),non-randomized studies,case-control studies,and cohort studies.The methodological quality of the included studies was evaluated using JBI Critical Appraisal Checklists for RCTs and for Quasi-Experimental Studies by two researchers independently.A narrative synthesis of intervention characteristics and health-related outcomes was performed.Results A total of 11 non-randomized studies and 9 RCTs were eligible,including 667 participants.The results supported our assumption that multisensory exercise improved balance in people with balance disorders.All of the 20 studies were believed to be of high or moderate quality.Conclusion Our study confirmed that multisensory exercise was effective in improving balance in people with balance disorders.Multisensory exercises could lower the risk of fall and enhance confidence level to improve the quality of life.Further research is needed to investigate the optimal strategy of multisensory exercises and explore the underlying neural and molecular mechanisms of balance improvement brought by multisensory exercises.