Installing yoyos is a very common operation. It is even, according to figures from the HAS (Haute Autorité de Santé), the second most frequent ENT surgery procedure, with more than 65,000 operations each year.
Diabolos or yoyos: what are they?
There are different terminologies used in common language to designate what in medical language are called transtympanic aerators (ATT). Yoyos, diabolos and even drains have the same objective: to ventilate the middle ear, the part of the ear located behind the eardrum. “There are several types, several shapes and they can be made of plastic or silicone.”, explains Dr Hadjedj.
Diabolos: what is it for and what are the indications?
“In the majority of cases, the tympanic aerator is placed in children who present with serous ear infections recurrent and resistant to medical treatment.”, explains the ENT surgeon. Serous or seromucous otitis (OSM) is characterized by the presence behind the eardrum of a thick liquid, glue, caused by inflammation of the ENT sphere. It can cause a feeling of fullness in the ear, autophony (sensation of hearing oneself speaking), a loss of hearing and, when it occurs in young children, a delay in language acquisition.
“The installation of a diabolo will allow this liquid to evacuate and therefore avoid recurrence of ear infections..”, adds Dr Hadjedj. The latter specifies, however, that there are other indications for the installation of yoyos, including in adults, for example in the event of a ventilation problem in the ear linked to the presence of a retraction pocket, this i.e. a retraction of the tympanic membrane, causing pain and a feeling of blocked ears. “In other somewhat special cases we may need to inject a treatment directly through the eardrum, which the aerator will allow..”, adds the specialist. Finally, the tympanic aerator can have a beneficial effect in the event of therapeutic failure in people suffering from Menière’s disease (hydrops).
Operation: how is the installation of eardrum vents carried out?
In children, the procedure takes place in the operating room under general anesthesia, for greater comfort and practicality, as the installation is not pleasant. In adults, however, the procedure most often takes place in consultation under local anesthesia. This is a fairly quick procedure that lasts around fifteen minutes. “It consists of making a hole in the eardrum, a paracentesis, surgically, and slide the aerator in so that it remains embedded in the eardrum. This open hole at the level of the eardrum will allow the middle ear to be re-ventilated via the external ear.”, explains Dr Hadjedj.
Complications after the procedure: what are the risks?
Complications after yoyo installation are very rare. “There may be a secondary infection (the ear is running) which requires local antibiotics. It also happens that the aerators fall off too early, so they must be replaced (10 to 20% of cases), or they do not eject when the time comes. ”, explains the ENT surgeon. In very rare cases, residual perforation of the eardrum may be observed, but this remains exceptional. “When the aerator is in place, supervision by the surgeon who installed it is necessary, particularly for devices that eject alone, to ensure that the eardrum is normal and the ear is well ventilated.”, adds Dr Hadjedj.
Yoyos: after how long do they fall off or when should they be removed?
There are two categories of yoyos: those which eject on their own between six months and a year after installation with the growth of the eardrum, and those which do not eject and which must be removed in consultation by pulling on them (T- tube).
Can you put your head underwater with yoyos and should you use protection?
We generally recommend paying attention to water in the ears, but this does not prevent you from washing or bathing normally. Scuba diving, on the other hand, is absolutely contraindicated and it is necessary for children who swim regularly to wear protection. “If water passes through aerator, there is indeed a risk of secondary infection.”, explains the ENT surgeon.
Can you fly with yoyos in your ears?
“There is no contraindication to flying for people who wear yo-yos. On the contrary, pressure exchanges are even better.”, reassures Dr Hadjedj.
Thanks to Dr Raphael Hadjedj, ENT surgeon.