{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:05:21Z","timestamp":1787018721744,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Insertion of tubes in an office setting and automated tube insertion devices were identified as high\u2010priority quality improvement opportunities during the update process for the 2013 clinical practice guideline on tympanostomy tubes from the American Academy of Otolaryngology\u2013Head and Neck Surgery. The guideline update group, however, decided to avoid any recommendations on these topics, based on limited research evidence, and instead selected a subset of group members to author this state of the art review, with the goal of facilitating informed decisions in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed through September 2021, Google search of device manufacturer websites, and SmartTots research website for articles on anesthesia neurotoxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>A state of the art review format emphasizing evidence from the past 5 years, with manual cross\u2010checks of reference lists of identified articles for additional relevant studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The existing literature is too sparse to make recommendations about procedure setting and optimal technique or assess long\u2010term outcomes. The role of automated devices is uncertain, given the increased equipment cost and limited information on characteristics of the proprietary preloaded tubes, including intubation duration and rates of otorrhea, obstruction, medialization, granulation tissue, and persistent perforation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Practice<\/jats:title>\n                    <jats:p>Whether to undertake in\u2010office tube insertion in awake children should be based on clinician experience, clinician ability to interact with and reassure caregivers, shared decisions with caregivers, and judgment regarding the level of cooperation (or lack thereof) to be expected from a given child. Clinicians should remain alert to new research and expect increasing queries from patients and families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01945998221074528","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T14:12:40Z","timestamp":1644415960000},"page":"219-223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Office Insertion of Tympanostomy Tubes and the Role of Automated Insertion Devices"],"prefix":"10.1002","volume":"166","author":[{"given":"Richard M.","family":"Rosenfeld","sequence":"first","affiliation":[{"name":"Department of Otolaryngology SUNY Downstate Health Sciences University Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Tunkel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth R.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat (Otolaryngology) Department Virginia Mason Medical Center Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812468849"},{"issue":"1","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","DOI":"10.1177\/0194599813490141","article-title":"Clinical practice guideline: tympanostomy tubes in children (update)","volume":"166","author":"Rosenfeld RM","year":"2022","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817735500"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812467004"},{"key":"e_1_2_7_6_1","unstructured":"SmartTots.Research articles. Accessed September 13 2021.https:\/\/smarttots.org\/research\u2010articles\/"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820917397"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/children7080096"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e318213be52"},{"key":"e_1_2_7_10_1","unstructured":"Food and Drug Administration.FDA drug safety communication: FDA approves label changes for use of general anesthetic and sedation drugs in young children. Accessed January 27 2020.https:\/\/www.fda.gov\/drugs\/drug\u2010safety\u2010and\u2010availability\/fda\u2010drug\u2010safety\u2010communication\u2010fda\u2010approves\u2010label\u2010changes\u2010use\u2010general\u2010anesthetic\u2010and\u2010sedation\u2010drugs"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.10.022"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aan.2018.07.010"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.16459"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12199\u2010020\u201000873\u20106"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238289"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003522"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005180"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199912000-00022"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815608366"},{"key":"e_1_2_7_20_1","unstructured":"American Academy of Otolaryngology\u2013Head and Neck Surgery.Position statement: in\u2010office placement of tubes in pediatric patients while awake. Accessed September 13 2021.https:\/\/www.entnet.org\/resource\/in\u2010office\u2010placement\u2010of\u2010tubes\u2010in\u2010pediatric\u2010patients\u2010while\u2010awake\/"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817707178"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215105005840"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480500266628"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000979"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70121-X"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X20903125"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.09.041"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03022879"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894211008063"},{"key":"e_1_2_7_30_1","unstructured":"Preceptis Medical.Humingbird TTs. Accessed September 13 2021.https:\/\/www.hummingbirdeartubes.com\/"},{"key":"e_1_2_7_31_1","unstructured":"Tusker Medical Inc.Tula system. Accessed September 13 2021.https:\/\/tulatubes.com\/"},{"key":"e_1_2_7_32_1","unstructured":"AventaMed.Solo TTD. Accessed September 13 2021.https:\/\/aventamed.com\/"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.533"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.11.003"},{"issue":"4","key":"e_1_2_7_35_1","first-page":"S1","article-title":"In\u2010office tympanostomy tube placement in children using iontophoresis and automated tube delivery","volume":"130","author":"Lustig LR","year":"2020","journal-title":"Laryngoscope"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110221"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816636102"},{"key":"e_1_2_7_38_1","first-page":"311","volume-title":"The Reference Manual of Pediatric Dentistry","author":"American Academy of Pediatric Dentistry"},{"key":"e_1_2_7_39_1","first-page":"553","article-title":"Myringotomy under topical anesthesia with phenol","volume":"51","author":"Plaza G","year":"2000","journal-title":"Acta Otorrinolaringol Esp"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/01945998221074528","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/01945998221074528","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/01945998221074528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T14:41:25Z","timestamp":1760971285000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/01945998221074528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1177\/01945998221074528"],"URL":"https:\/\/doi.org\/10.1177\/01945998221074528","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2]]},"assertion":[{"value":"2021-10-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}