{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:11:45Z","timestamp":1760962305815,"version":"build-2065373602"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,5,6]],"date-time":"2013-05-06T00:00:00Z","timestamp":1367798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Montgomery Safe\u2010T\u2010Tube deterioration and early biofilm colonization may explain the discomfort claimed by many patients and clinical failures. The aim of the study was to analyze the deterioration of Montgomery Safe\u2010T\u2010Tube morphological and mechanical properties in vivo in 16 patients by using microbiological methods, optical and electron microscopy, and engineering tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective controlled study at a single medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>The study, conducted from April 2007 to February 2012 at the \u201cSapienza\u201d University of Rome, was designed to collect 2\u00a0Montgomery Safe\u2010T\u2010Tubes from each patient. The first was removed 3 to 15\u00a0days after insertion (group A) and the second at least 90\u00a0days after (group B). Specimens underwent microbiologic assays, electron microscopic analysis, immunocytologic analysis, and mechanical tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Microorganisms were not isolated in 2\u00a0group A cases (12%), whereas they were in all group B cases. Biofilm was identified in 11 of 16 (69%) group A samples and in 16 of 16 (100%) group B samples (<jats:italic>P<\/jats:italic> =. 0149) using scanning electron microscopy. Immunohistochemistry showed monocyte\u2010granulocyte line cells producing interleukin\u20101\u03b2 on the external surfaces of Montgomery Safe\u2010T\u2010Tubes. The tensile test showed that the wear related to the longer period of use makes Montgomery Safe\u2010T\u2010Tubes more rigid than newer ones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early biofilm colonization takes place in Montgomery Safe\u2010T\u2010Tubes in most cases. The mechanical decay could be justified in part by the destructive biofilm activity and by the release of inflammatory effectors and enzymes.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599813488752","type":"journal-article","created":{"date-parts":[[2013,5,6]],"date-time":"2013-05-06T23:45:23Z","timestamp":1367883923000},"page":"269-276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Is Montgomery Tracheal Safe\u2010T\u2010Tube Clinical Failure Induced by Biofilm?"],"prefix":"10.1002","volume":"149","author":[{"given":"Massimo","family":"Fusconi","sequence":"first","affiliation":[{"name":"Department of Sensory Organs \u201cSapienza\u201d University of Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenza Rita","family":"Lo Vasco","sequence":"additional","affiliation":[{"name":"Department of Sensory Organs \u201cSapienza\u201d University of Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Delfini","sequence":"additional","affiliation":[{"name":"Astronautic, Electrical and Energy Engineering Department \u201cSapienza\u201d University of Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"De Virgilio","sequence":"additional","affiliation":[{"name":"Department of Sensory Organs \u201cSapienza\u201d University of Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Rita","family":"Taddei","sequence":"additional","affiliation":[{"name":"Interdepartmental Centre of Electron Microscopy (C.I.M.E.) 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