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In reply

Dr Berry has raised an interesting point regarding the sequence of steps for an error-free ventilation tube insertion. He suggests an addition to our 10 steps¹ to ensure that the sides of the incision are everted so that nothing is tucked into the middle ear, where it could form a cholesteatoma. However, he cites no evidence in support of such a risk being present. Could it be that no such evidence exists?

Previous work from our department has shown that over a 20-year-period, following the advent of ventilation tube insertion, the incidence of cholesteatomas did not change.² There are other studies that support such a view.^3-4

My colleagues and I accept that the term error in the context of our study refers to an undesirable event occurring during the procedure and that the occurrence and identification of a particular error do not equate to a harmful patient event. . . . [Full Text of this Article]

AUTHOR INFORMATION
S. S. M. Hussain, FRCS

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