Cerebral perfusion pressure in giraffe: modelling the effects of head-raising and -lowering

Loss of consciousness caused by positional changes of the head results from reduced cerebral blood flow (CBF). CBF is related to cerebral perfusion pressure (CPP). CPP is the difference between mean arterial pressure (MAP) at the head and intracranial pressure (ICP). The positional change of the giraffe head between ground level and standing upright is the largest of all animals yet loss of consciousness does not occur. We have investigated the possibility that an increase in CPP protects giraffe from fainting, using a mechanical model that functioned as an anatomical U-tube. It consisted of a rigid ascending “carotid” limb, a collapsible “brain” tube drained by a rigid, “vertebral venous plexus” (VVP) tube, and a collapsible “head” tube drained by a collapsible tube representing the “jugular vein”. The descending tubes could be rotated relative to the “carotid” tube to be horizontal, or at 30°, 45°, and 60° to the vertical to simulate changes in head position. Pressure at the top of the “carotid” tube was intracranial MAP, at the top of the “VVP” tube was ICP, and the difference CPP. In the simulated “head-up” position and a fluid flow rate of 4 L min⁻¹, CPP was ∼170 mmHg. With the VVP tube horizontal, CPP fell from ∼170 to 45 mmHg, but increased to ∼67 mmHg at 30° “down”, to ∼70 mmHg at 45° “down” and to ∼75 at 60° “down”. The fall in CPP in the head-down positions resulted from a decrease in viscous resistance in, and dissipation of pressure to, the “head” and “jugular” tubes. These data provide an estimate of cranial pressure changes in giraffe during positional changes of the head, and suggest that an increase in CPP plays a significant role in maintaining CBF during head-raising and that it may be an important mechanism for preventing fainting in giraffe.     

Guidance in vitro of the pollen tube to the naked embryo sac of torenia fournieri

The precise guidance of the pollen tube to the embryo sac is critical to the successful sexual reproduction of flowering plants. We demonstrate here the guidance of the pollen tube to the embryo sac in vitro by using the naked embryo sac of Torenia fournieri, which protrudes from the micropyle of the ovule. We developed a medium for culture of both the ovule and the pollen tube of T. fournieri and cocultivated them in a thin layer of solid medium. Although pollen tubes that had germinated in vitro passed naked embryo sacs, some pollen tubes that grew semi-in vitro through a cut style arrived precisely at the site of entry into the embryo sac, namely, the filiform apparatus of the synergids. When pollen tubes were unable to enter the embryo sac, they continuously grew toward the same filiform apparatus, forming narrow coils. Pollen tubes selectively arrived at complete, unfertilized embryo sacs but did not arrive at those of heat-treated ovules or those with disrupted synergids. These results convincingly demonstrate that pollen tubes are specifically attracted to the region of the filiform apparatus of living synergids in vitro.     

Studies of force acting on fish in the rotatory flow apparatus

Forces acting on symmetrically suspended wing-plates in the rotatory flow apparatus were measured at varied width and rev. min. ^–1 of the rotating tubes. Force plotted as function of tube diameter (or length of wing-plate) gives a sigmoid curve above 40 to 50 rev. min.^–1 (called the force/length curve) while the critical rev. min. ^–1 for cod is about 70. Features of the force-length curve may reasonably be expected to appear in plots of critical peripheral velocity against length of fish. Of the plots from 26 samples 73% showed features which are well compatible with those of the force/length curve.     

Textures and traction: how tube‐dwelling polychaetes get a leg up

By controlling the traction between its body and the tube wall, a tube‐dwelling polychaete can move efficiently from one end of its tube to the other, brace its body during normal functions (e.g., ventilation and feeding), and anchor within its tube avoiding removal by predators. To examine the potential physical interaction between worms and the tubes they live in, scanning electron microscopy was used to reveal and quantify the morphology of worm bodies and the tubes they produce for species representing 13 families of tube‐dwelling polychaetes. In the tubes of most species there were macroscopic or nearly macroscopic (~10 μm–1 mm) bumps or ridges that protruded slightly into the lumen of the tube; these could provide purchase as a worm moves or anchors. At this scale (~10 μm‐1 mm), the surfaces of the chaetal heads that interact with the tube wall were typically small enough to fit within spaces between these bumps (created by the inward projection of exogenous materials incorporated into the tube wall) or ridges (made by secretions on the interior surface of the tube). At a finer scale (0.01–10 μm), there was a second overlap in size, usually between the dentition on the surfaces of chaetae that interact with the tube walls and the texture provided by the secreted strands or microscopic inclusions of the inner linings. These linings had a surprising diversity of micro‐textures. The most common micro‐texture was a “fabric” of secreted threads, but there were also orderly micro‐ridges, wrinkles, and rugose surfaces provided by microorganisms incorporated into the inner tube lining. Understanding the fine structures of tubes in conjunction with the morphologies of the worms that build them gives insight into how tubes are constructed and how worms live within them.     

Do body and fin form affect the abilities of fish to stabilize swimming during maneuvers through vertical and horizontal tubes?

Goldfish, Carassius auratus, silver dollar, Metynnis hypsauchen, and angelfish, Pterophyllum scalare were induced to swim through narrow vertical and horizontal tubes ranging in length from 0 to 20 cm (approximately 0 to 3 times total fish length, FL). The ability to stabilize the body while negotiating these confined spaces was quantified as (1) the minimum width of vertical (w_v) and horizontal (w_h) tubes traversed, where width is the smaller cross-sectional dimension of the tube, (2) the ratio w_v/w_h, and (3) transit speed through the tubes. Tube width was expressed as relative width, obtained by dividing tube width by fish length. Minimum relative widths traversed increased from 0.15 to 0.19 in the order silver dollar > angelfish > goldfish for vertical tubes and from 0.17 to 0.18 in the order goldfish=silver dollar > angelfish for horizontal tubes. w_v/w_h increased from 0.91 to 1.10 in the order silver dollar=angelfish > goldfish. Minimum tube widths generally increased with tube length for vertical tubes. Although significant differences in relative minimum widths among species were found, these were small. In contrast, for horizontal tubes, there was no significant effect of tube length on minimum tube width for any species. Large differences were found in transit speed. Transit speed generally decreased as the tube length increased. The slope of the relationship between transit speed and tube length varied among species generally increasing from – 0.41 to – 1.16 for horizontal tubes in the order goldfish > silver dollar > angelfish and from – 0.42 to – 1.07 in the order silver dollar > goldfish > angelfish for vertical tubes. As a result, goldfish usually took longest to traverse tubes of zero length but the shortest time to traverse the longest tubes. In contrast, angelfish traversed short tubes in the least time and long tubes in the greatest time. Deeper bodied angelfish swam slowly and traversed tubes with difficulty because they required experience during each trial to replace median and paired fin with body and caudal fin swimming. According to our data, goldfish were best able to swim in confined spaces.     

The microsporidian spore invasion tube. The ultrastructure, isolation, and characterization of the protein comprising the tube

The extrusion apparatus of the microsporidian parasitic protozoan Nosema michaelis discharges an invasion (or polar) tube with a velocity suitalbe for piercing cells and injecting infective sporoplasm. The tube is composed of a polar tube protein (PTP) which consists of a single, low molecular weight polypeptide slightly smaller than chymotrypsinogen-A. Assembled PTP tubes resist dissociation in sodium dodecyl sulfate and brief exposures in media at extreme ends of the pH range; however, the tubes are reduced by mercaptoethanol and dithiothreitol. When acidified, mercaptoethanol-reduced PTP self-assembles into plastic, two-dimensional monolayers. Dithiothreitol-reduced PTP will not reassemble when acidified. Evidence is presented which indicates that PTP is assembled as a tube within the spore; that the ejected tube has plasticity during sporoplasm passage; and, finally, that the subunits within the tube polymer are bound together, in part, by interprotein disulfide linkages.     

Fast pollen tube growth in Conospermum species

BACKGROUND AND AIMS: An unusual form of pollen tube growth was observed for several Conospermum species (family Proteaceae). The rate of pollen tube growth, the number of tubes to emerge and the ultrastructure of these tubes are given here. METHODS: Pollen was germinated in vitro in different sucrose concentrations and in the presence of calcium channel blockers, and tube emergence and growth were recorded on a VCR. Measurements were taken of the number of tubes to emerge and rate of tube emergence. Pollen behaviour in vivo was also observed. The ultrastructure of germinated and ungerminated pollen was observed using TEM. RESULTS: After 10 s to 3 min in germination medium, up to three pollen tubes emerged and grew at rates of up to 55 micro m s(-1); the rate then slowed to around 2 micro m s(-1), 30 s after the initial growth spurt. Tubes were observed to grow in pulses, and the pulsed growth continued in the presence of calcium channel blockers. Optimal sugar concentration for pollen germination was 300 g L(-1), in which up to 81 % of pollen grains showed fast germination. Germination and emergence of multiple tubes were observed in sucrose concentrations of 100-800 g L(-1). The vegetative and generative nuclei moved into one of the tubes. Multiple tubes from a single grain were observed on the stigma. Under light microscopy, the cytoplasm in the tube showed a clear region at the tip. The ultrastructure of C. amoenum pollen showed a bilayered exine, with the intine being very thick at the pores, and elsewhere having large intrusions into the plasma membrane. The cytoplasm was dense with vesicles packed with inner tube cell wall material. Golgi apparatus producing secretory vesicles, and mitochondria were found throughout the tube. The tube wall was bilayered; both layers being fibrous and loosely packed. CONCLUSIONS: It is proposed that, for Conospermum, initial pollen tube wall constituents are manufactured and stored prior to pollen germination, and that tube extension occurs as described in the literature for other species, but at an exceptionally fast rate.     

The active tube clearance system: a novel bedside chest-tube clearance device

OBJECTIVE:: Chest-tube clogging can lead to complications after heart and lung surgery. Surgeons often choose large-diameter chest tubes or place more than one chest tube when concerned about the potential for clogging. The purpose of this report is to describe the design and function of a proprietary active tube clearance system, a novel device that clears clots and debris from chest tubes. DEVICE DESCRIPTION:: The active tube clearance system is a novel chest tube clearance apparatus developed to maintain chest tube patency. Chest tube clearance is achieved by advancing the specially designed clearance member back and forth within the chest tube under sterile conditions, breaking down and pulling clots back toward the drainage receptacle, thereby leaving the inner portion of the chest tube clear of any obstructing material. CONCLUSIONS:: By maintaining chest tube patency, chest tube drainage can be performed more safely, and this apparatus may possibly lead to the use of smaller chest tubes and less invasive insertion techniques.     

Ultrastructure of feeding tubes formed in giant-cells induced in plants by the root-knot nematodeMeloidogyne incognita

Summary The plant pathogenic nematodeMeloidogyne incognita forms conspicuous tubular structures referred to as feeding tubes in special food cells, called giant-cells, induced and maintained in susceptible host roots by feeding nematodes. Feeding tubes are formed by nematode secretions injected into giant-cells via a stylet and apparently function to facilitate withdrawal of soluble assimilates by the parasite. In giant-cells in roots of the four host species examined in this study, feeding tube morphology was identical. Tubes were straight to slightly curved structures just less than 1 μm wide and up to slightly more than 70 μm long. At the ultrastructural level, each tube consisted of a 190–290 nm thick, electron-dense, crystalline wall surrounding an electron-transparent lumen with a diameter of 340–510 nm. The distal end of the tube was sealed with wall material. Older tubes were found free in the host cytoplasm while the proximal ends of young tubes were attached to the host cell wall via short wall ingrowths through which the nematode's stylet was inserted. An elaborate membrane system was associated with the feeding tubes and was most extensive around newly formed tubes. Contiguous to the feeding tube wall, this membrane system consisted of strands of smooth endoplasmic reticulum while rough endoplasmic reticulum predominated toward the outer margin of the membrane system. Vacuoles and mitochondria were excluded from a zone of cytoplasm surrounding feeding tubes. This zone of exclusion, as well as the membrane system noted above, tended to be less pronounced or absent around older tubes no longer being used by the nematode.     

Germination and <Emphasis Type="Italic">In Vitro</Emphasis> Growth of Petunia Male Gametophyte Are Affected by Exogenous Hormones and Involve the Changes in the Endogenous Hormone Level

The data obtained characterize the changes in the contents of endogenous phytohormones (IAA, cytokinins, GA, and ABA) in germinating pollen grains and growing pollen tubes of a self-compatible clone of petunia (sPetunia hybrida L.) within an 8-h period under in vitro conditions. The hydration and initiation of germination of pollen grains brought the ABA content down to a zero level, while the levels of GA, IAA, and cytokinins increased 1.5–2-fold. Later, in the growing pollen tubes, the GA content increased twofold, while the levels of IAA and cytokinins decreased. The exogenous ABA and GA₃ considerably promoted pollen germination and pollen tube growth; however, only the treatment with GA₃ produced the maximum length of pollen tubes. The exogenous IAA promoted and the exogenous cytokinins hindered the growth of pollen tubes. The membrane potential, as assessed with a potential-sensitive dye diS-C₃-(5), considerably increased in the pollen grains treated with ABA and benzyladenine, whereas IAA and GA₃ did not practically affect it. The authors conclude that the mature pollen grains contain the complete set of hormones essential for pollen germination and pollen tube growth. ABA, GA, and IAA together with cytokinins control the processes of pollen grain hydration, germination, and pollen tube growth, respectively.__________Translated from Fiziologiya Rastenii, Vol. 52, No. 4, 2005, pp. 584–590.Original Russian Text Copyright © 2005 by Kovaleva, Zakharova, Minkina, Timofeeva, Andreev.     

Oil extraction from microalgae for biodiesel production

This study examines the performance of supercritical carbon dioxide (SCCO₂) extraction and hexane extraction of lipids from marine Chlorococcum sp. for lab-scale biodiesel production. Even though the strain of Chlorococcum sp. used in this study had a low maximum lipid yield (7.1 wt% to dry biomass), the extracted lipid displayed a suitable fatty acid profile for biodiesel [C18:1 (∼63 wt%), C16:0 (∼19 wt%), C18:2 (∼4 wt%), C16:1 (∼4 wt%), and C18:0 (∼3 wt%)]. For SCCO₂ extraction, decreasing temperature and increasing pressure resulted in increased lipid yields. The mass transfer coefficient (k) for lipid extraction under supercritical conditions was found to increase with fluid dielectric constant as well as fluid density. For hexane extraction, continuous operation with a Soxhlet apparatus and inclusion of isopropanol as a co-solvent enhanced lipid yields. Hexane extraction from either dried microalgal powder or wet microalgal paste obtained comparable lipid yields.     

Influence of phototropic response of spore germ tubes on infection process inColletotrichum lagenarium andBipolaris oryzae

The germ tubes ofColletotrichum lagenarium showed negative phototropism to UV-blue (300–520 nm) and far-red (>700 nm) regions with maximum in the near ultraviolet (NUV) region, while monochromatic radiations of 575–700 nm (yellow-red region) induced positive phototropism with maximum in the red region. Green light (520–575 nm) was ineffective. Negative phototropism-inducing wavelength regions inhibited germ tube growth and positive phototropism-inducing wavelength regions promoted it significantly.Bipolaris oryzae did not show any phototropic response and light did not affect the germ tube growth. These results indicate that the lens effect, in combination with the light growth reaction and light growth inhibition, is the mechanism of the phototropism of germ tubes ofC. lagenarium. NUV radiation, which induced negative phototropism ofC. lagenarium, promoted appressorium formation, while red light, which induced positive phototropism, suppressed it significantly. In the case ofB. oryzae, light did not affect the infection structure formation. These results indicate that negative phototropism of germ tubes ofC. lagenarium favors the infection process by facilitating the contact of the tips of germ tubes with the host surface, while positive phototropism has the opposite effect.     

Clinically Relevant Concentration Determination of Inhaled Anesthetics (Halothane,Isoflurane, Sevoflurane,and Desflurane) by <Superscript>19</Superscript>F NMR

Biophysical studies of protein–anesthetic interactions using nuclear magnetic resonance (NMR) spectroscopy are often conducted by the addition of micro amounts of neat inhaled anesthetic which yields much higher than clinically relevant (0.2–0.5 mM) anesthetic concentrations. We report a ¹⁹F NMR technique to measure clinically relevant inhaled anesthetic concentrations from saturated aqueous solutions of these anesthetics (halothane, isoflurane, sevoflurane, and desflurane). We use a setup with a 3-mm NMR tube (containing trifluoroacetic acid as standard), coaxially inserted in a 5-mm NMR tube containing anesthetic solution under investigation. All experiments are conducted in a 5-mm NMR probe. We also have provided standard curves for four inhaled anesthetics using NMR technique. The standard curve for each of these anesthetics is helpful in determining the prerequisite amount of aqueous anesthetic solution required to prepare clinically relevant concentrations for protein–anesthetic interaction studies. Parts of the results to be presented at Society for Neuroscience meeting, 2008.     

Pollen tube penetration and fertilization in Lilium longiflorum (Liliaceae)

The ultrastructure of the embryo sac, nucellus, and parts of the micropyle of Lilium longiflorum were studied both before and after pollen tube penetration to examine the interactions between ovule and pollen tube, using transmission electron microscopy and light microscopy. Before pollen tube penetration the egg cell and two synergids are similar. No filiform apparatus was detected and no synergid degeneration occurs prior to pollen tube penetration. The polar nuclei do not fuse until fertilization. No differences in embryo sac ultrastructure were detected between pollinated ovules unpenetrated by pollen tubes and unpollinated flowers of a comparable age. Shortly after the discharge of the pollen tube two enucleated cytoplasmic bodies with different ribosome densities were observed in the degenerated cytoplasm. These structures border both on the central cell and the egg cell as well as each other and are interpreted as remains of sperm cytoplasm after transmission of sperm nuclei. In the central cell both the sperm nucleus and the polar nuclei are associated with endoplasmic reticulum (ER). ER is thought to be a transport mechanism to achieve contact between the haploid polar nuclei and the sperm nucleus. In the egg cell sperm nucleus alignment is not visibly achieved by ER. The persistent cells of the egg apparatus and the central cell appear to become more metabolically active after pollen tube penetration. Pollen tube penetration already occurs despite the absence of a filiform apparatus and a low level of differences between the cells of the egg apparatus.     

Pentachlorophenol affects mitochondria and induces formation of golgi apparatus-endoplasmic reticulum hybrids in tobacco pollen tubes

Summary The toxic effect of pentachlorophenol (PCP) on the growth and ultrastructure of tobacco pollen tubes was tested using a semivivo technique of tube culture. In this technique the pollen tubes were allowed to grow in the pistilin situ for 24 hr before they protruded from the cut end of the style and came into contact with the medium containing PCP. The inhibitory effect of different PCP concentrations was determined by measuring the length of tube bundles. The intracellular action of PCP was analysed by electron microscopy. This biocide caused four obvious alterations in the pollen tube ultrastructure: (1) swelling of the mitochondrial saccules; (2) enlargement of the dictyosomes by the increase of the cisternal diameter and the number of cisternae per stack; (3) formation of cup-shaped Golgi apparatus-endoplasmic reticulum hybrid structures (GER hybrids) showing continuities of ER and Golgi cisternae; (4) formation of stacked and/or concentric arrangements of rough ER cisternae. It is suggested that swelling of saccules was directly due to the uncoupling of oxidative phosphorylation whereas the changes of the endomembrane system were caused by energy depletion due to the inhibition of ATP synthesis. These changes are consistant with dynamic concepts of dictyosome and ER function when membrane formation exceeds membrane use in the production of secretory and transition vesicles. Thus, the enlargement of the dictyosomes and the formation of GER hybrids are thought to result from inhibition of budding of vesicles from the Golgi apparatus or from both the ER and the Golgi apparatus, respectively.     

Effect of Capping Protein on a Growing Filopodium

Filopodia, or the growth of bundles of biological fibers outwards from a biological cell surface while enclosed in a membrane tube, are implicated in many processes vital to life. This study models the effect of capping protein on such filopodia, paying close attention to the polymerization dynamics of biological fiber bundles within long membrane tubes. Due to the effects of capping protein, the number of fibers in the filopodium bundle decreases down the length of the enclosing membrane tube. This decrease in the number of fibers down the length of a growing filopodium is found to have profound implications for the dynamics and stability of filopodia in general. This study theoretically finds that the presence of even a relatively modest amount of capping protein can have a large effect on the growth of typical filopodia, such as can be found in fibroblasts, keratocytes, and neuronal growth cones. As an illustration of this modeling work, this study investigates the striking example of the acrosomal reaction in the sea cucumber Thyone, whose filopodia can grow remarkably quickly to ∼90 μm in ∼10 s, and where the number of fibers is known to decrease down the length of the filopodium, presumably due to progressive fiber end-capping occurring as the filopodium grows. Realistic future dynamical theories for filopodium growth are likely to rely on an accurate treatment of the kinds of capping protein effects analyzed in this work.     

Use of geotextile tubes with chemical amendments to dewater dairy lagoon solids

Three geo-textile filtration tubes were used to dewater lagoon solids from a first stage dairy lagoon using chemical amendments (aluminum sulfate and a polymer) to enhance the separation process. This experiment had previously been done without chemical amendment. The chemical amendments speeded the dewatering process so that filling could be accomplished sooner, and also increased the removal rate of nutrients, especially phosphorus into the solid phase. Chemically amended slurry was pumped from the lagoon into the tube with the filtered liquid seeping from the tube and returning to the lagoon. Each tube was filled five to six times at 2-5-day intervals, and then allowed to dewater for 2 weeks before sampling the solid fraction in the tube. Separation efficiency improved from 79% to 99% for phosphorous and from 92% to 100% for organic nitrogen with chemical amendment. Time required for dewatering was significantly reduced by chemical amendment. Cost for the tube was approximately $10/m(3) of recovered solids with no chemical amendment and cost including the chemicals was approximately $14/m(3) of recovered solids.     

Sterilization of various diameter dead-ended tubes

Effect of tube diameter on steam-in-place sterilization of dead-ended tubes was studied by examining temperature profiles and rates of kill of Bacillus stearothermophilus spores. Time required for sterilization was determined for 9.4-cm-long tubes with various inside diameters from 0.4 to 1.7 cm. Sterilization time increased with decreasing tube diameter. Experimentally measured kill kinetics in 1.7-cm tubes were in agreement with those predicted if measured temperatures represented saturated steam. A 12-log spore reduction was achieved in 1.7-cm diameter vertical and horizontal tubes in less than 63 minutes. For smaller diameter tubes, entrapped air remained after 2 hours and rates of kill were very dependent on position within the tube, tube diameter, and tube orientation with respect to the gravitational vector. Times to achieve a 1-log drop in spore population in the smaller tubes were as much as 10 times greater than those expected if measured temperatures represented saturated steam. Sterilization was not achieved throughout the 0.4-cm tubes. Recommendations are made for including steam bleeders or using prevaccum cycles for these smaller diameter tubes. (c) 1993 John Wiley & Sons, Inc.     

Plasmatubules in the pollen tubes of Nicotiana sylvestris

Ultrastructural studies of the pollen tubes of Nicotiana sylvestris grown in the pistil revealed an extensive development of plasmatubules formed by evaginations of the plasma membrane. The plasmatubules occurred as twisted tubular structures in the periplasmic space along the tube wall and, in cross section, exhibited circular profiles with an outer diameter of 28±4 nm. They were also seen in deep, pocket-like invaginations of the plasma membrane and in this case the profiles had an outer diameter of 34±8 nm. In the pocket-like invaginations they were partially branched and often closely packed to form groups with obvious patterns. The enlargement of the plasma-membrane area resulting from plasmatubules formed along the tube wall was about six-to tenfold. Pollen tubes grown in vitro exhibited poorly developed plasmatubules. It is suggested that the large extension of the plasma membrane could enhance the uptake of nutrients, and thus might be responsible for the comparatively fast growth of pollen tubes in the pistil. Moreover, it is also assumed that the turnover rate of the Golgi apparatus must be higher in pollen tubes growing in vivo than in vitro, in order to provide a sufficient amount of membrane for the formation of the plasma membrane with its tubular modifications.     

The Protective Effect of Adenoidectomy on Pediatric Tympanostomy Tube Re-Insertions: A Population-Based Birth Cohort Study

Objectives

Adenoidectomy in conjunction with tympanostomy tube insertion for treating pediatric otitis media with effusion and recurrent acute otitis media has been debated for decades. Practice differed surgeon from surgeon. This study used population-based data to determine the protective effect of adenoidectomy in preventing tympanostomy tube re-insertion and tried to provide more evidence based information for surgeons when they do decision making.

Study Design

Retrospective birth cohort study.

Methods

This study used the National Health Insurance Research Database for the period 2000–2009 in Taiwan. The tube reinsertion rate and time to tube re-insertion among children who received tympanostomy tubes with or without adenoidectomy were compared. Age stratification analysis was also done to explore the effects of age.

Results

Adenoidectomy showed protective effects on preventing tube re-insertion compared to tympanostomy tubes alone in children who needed tubes for the first time (tube re-insertion rate 9% versus 5.1%, p = 0.002 and longer time to re-insertions, p = 0.01), especially those aged over 4 years when they had their first tube surgery. After controlling the effect of age, adenoidectomy reduced the rate of re-insertion by 40% compared to tympanostomy tubes alone (aHR: 0.60; 95% CI: 0.41–0.89). However, the protective effect of conjunction adenoidectomy was not obvious among children with a second tympanostomy tube insertion. Children who needed their first tube surgery at the age 2–4 years were most prone to have tube re-insertions, followed by the age group of 4–6 years.

Conclusions

Adenoidectomy has protective effect in preventing tympanostomy tube re-insertions compared to tympanostomy tubes alone, especially for children older than 4 years old and who needed tubes for the first time. Nonetheless, clinicians should still weigh the pros and cons of the procedure for their pediatric patients.