Reliability of a tympanic thermometer in measuring temperatures in children after minor ear surgery

Is tympanic infrared thermometry valid in non-naive tympanic membranes?

OBJECTIVE

To investigate the impact of with tympanostomy tubes (TT) on infrared tympanic membrane thermometer (ITMT) results and to provide a systematic review of ITMT results in non-naïve tympanic membranes.

STUDY DESIGN

Original prospective blinded case series and systematic literature review.

SETTINGS

A single tertiary university-affiliated medical center.

METHODS

ITMT measurements of patients with unilateral TT and contralateral naïve control ear were randomly conducted by a single investigator blinded to the TT side before and after cerumen was removed from the external auditory canals. A systematic literature search of "MEDLINE" via "PubMed," "Embase," and "Google Scholar" on comparable published cases was performed.

RESULTS

The mean paired differences (95% confidence interval [CI]) between ventilated and non-ventilated ears before and after cerumen removal were 0.08 ºC/0.14 ºF (-0.04 to 0.19 ºC/- 0.07º-0.34º) and 0.62 ºC/1.12 ºF (0.04-0.25 ºC/0.07-0.45 ºF), respectively (P < 0.001 and P = 0.01, respectively).

CONCLUSION

These findings support the validity and accuracy of ITMT in the setting of ventilated ears.

Comparison of bilateral eardrum temperatures measured using an infrared tympanic thermometer before and after surgery in patients with chronic otitis media

This study aimed to investigate the effect of chronic otitis media (COM) and COM surgery on infrared tympanic thermometer measurements. We retrospectively reviewed the medical records of 192 patients (192 surgery cases) who underwent surgery for COM and whose bilateral tympanic membrane temperature was measured with an infrared tympanic thermometer the day before surgery and at 2, 3, 4, and 6 months after surgery. Patients underwent surgery for COM in 1 ear, the other eardrum was intact. Patients who underwent tympanoplasty, simple mastoidectomy, and canal wall up mastoidectomy, surgeries performed to preserve the ear canal, were included in group A, and patients who underwent canal wall down mastoidectomy, a surgery to remove the ear canal, were included in group B. There were 115 and 77 patients in groups A and B, respectively. The mean temperature on the side with COM measured the day before surgery was 37.09°C ± 0.325°C and the mean temperature on the opposite normal side was 37.03°C ± 0.330°C (P = .000). In group A, the eardrum temperature on the surgical and contralateral side was not statistically different after surgery (P = .439). The temperature difference between both sides of the eardrums (dTemp) changed from 0.056°C before surgery to 0.014°C after surgery (P = .008). However, in group B, which canal wall down mastoidectomy was performed, the eardrum temperature of the surgical side was higher than that on the other side (P = .001). The dTemp increased up to 0.15°C after surgery (P = .000). The temperature of the eardrum was slightly increased by COM. The COM surgeries, which preserve the ear canal, brought the temperature of the eardrum close to that of the normal eardrum, and the surgery to remove the ear canal raised the temperature of the eardrum.

Postexercise heart rate recovery in children: relationship with power output, blood pH, and lactate

The aim of the present study was to determine whether differences in age-related heart rate recovery (HRR) kinetics were associated with differences in power output, blood lactate concentration ([La]b), and acidosis among children, adolescents, and adults. Ten prepubertal boys (aged 9.6 +/- 0.7 years), 6 pubertal boys (aged 15.2 +/- 0.8 years), and 7 men (aged 20.4 +/- 1.0 years) performed 10 repeated 10-s all-out cycling sprints, interspersed with 5-min passive recovery intervals. Mean power output (MPO) was measured during each sprint, and HRR, [La]b, and acidosis (pHb) were determined immediately after each sprint. Children displayed a shorter time constant of the primary component of HRR than adolescents and adults (17.5 +/- 4.1 vs. 38.0 +/- 5.3 and 36.9 +/- 4.9 s, p < 0.001 for both), but no difference was observed between adolescents and adults (p = 1.00). MPO, [La]b, and pHb were also lower in children compared with the other 2 groups (p < 0.001 for both). When data were pooled, HRR was significantly correlated with MPO (r = 0.48, p < 0.001), [La]b (r = 0.58, p < 0.001), and pHb (r = -0.60, p < 0.001). Covarying for MPO, [La]b, or pHb abolished the between-group differences in HRR (p = 0.42, p = 0.19, and p = 0.16, respectively). Anaerobic glycolytic contribution and power output explained a significant portion of the HRR variance following high-intensity intermittent exercise. The faster HRR kinetic observed in children appears to be related, at least in part, to their lower work rate and inherent lack of anaerobic metabolic capacity.