In the event of repeated serery otitis, the installation of a diabolo, or a yoyo, is frequently offered in children, but also in adults. How is it going? And the withdrawal? From what age? Update with ENT, Ali Abbas and Clémence Pavillon-Maisonnier doctors.
A diabolo is the old appellation ofTranstympanic aerator (ATT). It is a silicone medical device posed through the eardrum allowing theInterior ventilation. These are small plastic tubes that are placed at the level of the eardrum in order to create a passage to ventilate the middle ear (which is behind the eardrums) to make the liquid disappear. The installation of a diabolo thus improves the transmission of sound and avoid the containment of bacteria.
“”It’s the same: we talk about Diabolo, Yoyo, Transtympanic Drain or ATT“Explains Dr. Abbas. Diabolo or Yoyo are the old names of transtympanic aerator. There are 2 types:
- short -lived (There are 9 months left and spontaneously falls): Diabolo, Yoyo because the aerator has the shape of a diabolo or a yoyo.
- long -lasting (There are 2 years left and requires removal under general anesthesia): called T-Tube because the aerator has the form of a T.
In children, the main indication is theserummary otitis which is characterized by clear secretions stuck behind the tympanum, which lasts more than 3 months to which is added a deafness greater than 25dB. This has the consequences of a delay in language and/or disorder pronunciation. You can also put a diabolo in case of Recurrent otitis acute otitis repeated purulent in children over 6 years old, and Evolutionary tympanic retraction in children and adults. Recall that yoyos are placed when basic medical treatments are not enough. “”Before putting yoyos, we try other treatments. In the event of serous otitis for example, we can try to use corticosteroid antibiotics as well as corticosteroids in the nose, and we cannot renew this treatment several times“, Explains Dr. Clémence Pavillon-Maisonnier, which also recalls that the best prevention remains daily nose washing with savory serums. Do not hesitate to consult, if you have the feeling that your child does not hear well. To diagnose a hearing problem with a small one, here are some bearings: the child is grumpy, he is turbulent at school, a little difficult at home …
- The installation of transtympanic aerator is done in the operating room under general anesthesia in children. It only lasts a few minutes (about two to three minutes) for each ear,
- Under microscope, the ENT makes a paracensis (a very small incision in the tympanum) and aspire the liquid.
- He introduces the aerator there which will have set itself through the eardrum.
“”In children it is readily associated with adenoidectomy (ablation of adenoid vegetations). The aerator installation is an painless procedure“Specifies the doctor.
There is no minimum age to install a diabolo
“”There is no minimum age to install a diabolo“Exhibits Dr. Abbas. He specifies that” we consider that the anesthetic risks are less important from a year and a half“In addition, there is no choice according to the season for the installation of aerator as one might think. Diabolo is also indicated in adults, more often unilateral, in the office under local anesthesia.
It is very variable. On average, diabolo is kept 1 to 2 years in childrenmore in adults according to the indications. “”If necessary, it is then possible to put other types of aerators which are called “single-tubes” and which stay longer“, Specifies Clémence. In the form of T, they place themselves in the same way under general anesthesia, but unlike the Yoyos which fall naturally, the T-Tubes are removed under anesthesia.
In general, we ask to avoid any water in the ear during the first month following the installation of diabolo. After this period, we only ask forAvoid putting shampoo in the ears And to dive your head beyond half a meter. “”Some doctors and parents are more careful and prefer to eviction of water throughout the port of diabolo, but without scientific base“Add Dr. Abbas.
There is no contraindication to flying with a diabolo.
If ever diabolo came to fall, you should not try to put it on your own but consult your ENT.
It is ENT that removes diabolo if it leads to infections or exceeds the expected duration. “”In adults, this is done in the office without anesthesia. In children, we prefer to do it either at the mask in a dedicated consultation room or in the operating room under general anesthesia but without intubation “ explains Dr. Abbas.
It can happen to have a local infection. In this case, it will be enough to treat by local antibiotic drops, “But it’s not serious at all“, she reassures. In rarer cases, when there is a lot of liquid in the ear, there may be a risk of dizziness.
Thank you to Dr Ali Abbas, ENT and Dr Clémence Pavillon-Maisonnier, ENT at Foch Hospital in Suresnes.
