Monday, May 18, 2009

Summer seems like its almost here! In my peds office, we're seeing fewer patients overall, but still a fair number of viral infections and ear infections, especially in the little kids. For those infants who come in with complaints of "he won't sleep" or "fussy" and "fever and runny nose", its important to separate the treatable conditions from the viremias and teething issues. To do that you've GOT to visualize the ear drum adequately to rule out or in otitis.

For the little kids, my best tip is to do everything with the child held on mom's shoulder. Mom should be backed up against the table for support, and she holds the child in the "L" formed by her shoulder and neck. The babies turn their heads out-ward automatically. I use the heel of my hand to immobilize the child's head (or at least keep them from turning), and my thumb and finger to extend the ear and straighten the ear canal. If there's wax, I like the white FlexLoop or lighted VersaLoop, depending on the size of the ear canal and how well I can see. Usually I can remove enough wax to make my diagnosis in a relatively quick and painless fashion. Being able to confidently tell the parent that there's NOT an infection because you got a good look at the ear drum is worth its weight in suckers!

Any tips you have for examining kids (or adults) and ear wax removal would be appreciated by all.

Till then.

James Huttner MD

Tuesday, May 12, 2009

Another week here at Bionix. We're now on twitter, so you can follow us there--it'll get busier during the fall tradeshow season-- or on my blog.

The folks in sales and marketing just got back from Primed West. We had an amazing turnout at the show, and some great response to our products. One device that generated lots of interest was our OtoClear Safe Irrigation System. The OtoClear was developed in response to those of you who have the need to irrigate patient's ears in your practice, but were tired of the need to tie up a room and a nurse for forever, and the pain and mess associated with the old style metal ear syringes. Many of you have tried alternative devices and techniques-- a syringe and angiocath, the Waterpik, etc. Sometimes they work, more often they don't, and they still can cause pain and create a mess.

So we created the OtoClear tip. This thing works great! I use it in my office, and I can clear impacted wax in just a few minutes. I use body temperature tap water (I don't use peroxide, but you could), and drape the patient with a towel to prevent drips. The patient holds the catch basin, and I hold and manipulate the OtoClear. Whichever water delivery system you like best is what you should use.

The portable Waterpik is great for impactions, and has the fastest and greatest volume of water delivery. This unit is perfect for larger volume facilities. A drawback is that the noise it creates can bother some patients. The Spray Wash bottle is quieter, has a large reservoir volume, and is very convenient and easy to use. It’s a cost-effective option for those offices that perform only a few irrigation procedures each week

Each tip is single patient use, and this prevents cross-contamination. Contraindications are standard-- known perforation or tubes, active infection, etc. Complications are rare, and the safety of the system is unparalleled. We did an early study with Children's Hospital of Pittsburgh, and you can view it at http://www.bionix.com/Images/OtoClearStudy.pdf .

There's more on irrigation on our web site at https://www.bionix.com, and on our "Curettage and Irrigation" video (under the "New Web Videos" heading). Check it out.

More soon.

--James Huttner MD

Tuesday, May 5, 2009

Greetings

To all, greetings.

My name is Jim Huttner, and I developed the first Bionix Safe Ear Curette when I was a resident, some 27 years ago. Since then, I've been a practicing pediatrician as well as being the "in house" inventor of ear curettes for Bionix Medical Technologies. Most of the ear curette designs came about as a result of problems of ear wax removal encountered by physicians in their practices. We would meet them at national meetings--AAP, AAFP, PRI-Med's, etc.-- and they would discuss how they liked or disliked one curette or the other, noting that they were great for soft wax, but not stiff enough for hard wax, or too large to curette through the otoscope speculum, things like that. So I would go back, and with the help of our engineering staff would develop the next curette in the Safe Ear Curette line. (It helped a great deal that I was able to test out our new designs on my pediatric patients.)

We used that same kind of input/feedback to create the Lighted Ear Curette, bringing illumination and visualization to what used to be a blind procedure. And we also created the OtoClear Safe Irrigation System in response to the expressed need for a better way to irrigate cerumen from ears, one that would work safely and effectively on all patients.

Over the coming weeks and months, I will be writing about some of the challenges and experiences I've had removing wax (and other objects) from kids ears. I invite you to write and post your experiences, as well. Hopefully, we'll all learn better techniques for dealing with this common problem--wax impaction/obstruction-- and maybe some of those discussions will lead to the next new innovation in cerumen removal.

I'll look forward to reading your posts.

--James Huttner MD