In-Office Tympanostomy Tube Placement in Children (OTTER)

NCT ID: NCT03323736

Last Updated: 2022-05-26

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

370 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-31

Study Completion Date

2021-03-25

Brief Summary

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A prospective, single-arm, multicenter study to evaluate effectiveness and safety of Tymbion iontophoresis and tympanostomy tube placement using the Tula Iontophoresis and Tube Delivery Systems for children in an office setting.

Detailed Description

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The objective of this study is to evaluate effectiveness and safety of tympanostomy tube (TT) placement in children following local anesthesia in a physician's clinic setting (henceforth referred to as 'in-office'). Local anesthesia using Tymbion, a lidocaine-based anesthetic, is delivered by the Tula Iontophoresis System (IPS) and TT placement is implemented by the Tula Tube Delivery System (TDS).

The IPS will be used to facilitate anesthetic delivery to the tympanic membrane (TM). The Iontophoresis System consists of an Iontophoresis Control Unit, Iontophoresis Earsets and a return electrode patch. The Control Unit monitors and delivers a fixed amount of charge (ie, dose) to the patient through the Earsets(s) and alerts the operator when charge delivery is complete. The lidocaine-based solution used for local anesthesia of the TM is Tymbion (2% lidocaine HCl/ 1:100,000 epinephrine).

The TDS is a mechanical device that integrates a myringotomy blade, tympanostomy tube and tube inserter for TT placement with a user-controlled activation. The study will use the TDS with a grommet-type tube.

This pivotal study will include up to 422 children ages 6 months through 12 years indicated for tympanostomy tube placement enrolled at approximately 15 to 25 investigational centers in the US and Canada. The pivotal cohort consists of 222 subjects. In addition, up to 100 subjects will be enrolled as lead-in procedures in the OR using the TDS and up to 100 subjects will be enrolled as lead-in procedure in-office (using IPS and TDS) as the surgeons' initial experience with the technology prior to enrolling into the pivotal cohort.

All pivotal and lead-in subjects will follow the same study protocol assessments and visit schedule consisting of a screening visit, procedure visit and 3-week, 6 month, 12 month, 18 month, and 24 month post-procedure follow-up visits. Lead-in procedures will be analyzed separately from the pivotal pediatric cohort.

Conditions

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OME - Otitis Media With Effusion AOM - Acute Otitis Media

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Pivotal cohort is single arm. Physician initial subjects evaluated in separate cohorts but not included in primary and secondary analyses.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pivotal Cohort

Active Tymbion iontophoresis and tube insertion using the Tube Delivery System in-office.

Group Type OTHER

Iontophoresis & tube placement

Intervention Type COMBINATION_PRODUCT

Subjects will receive active Tymbion iontophoresis and will have tubes placed in-office using the Tube Delivery System in all ears indicated for tube placement.

Office Lead-In Cohort

Active Tymbion iontophoresis and tube insertion using the Tube Delivery System in-office. Physician initial in-office iontophoresis and tube insertion procedures (minimum of 2 subjects per investigator).

Group Type OTHER

Iontophoresis & tube placement

Intervention Type COMBINATION_PRODUCT

Subjects will receive active Tymbion iontophoresis and will have tubes placed in-office using the Tube Delivery System in all ears indicated for tube placement.

OR Lead-In Cohort

Tubes insertion using the Tube Delivery System in the operating room (OR). Physician initial tube insertion procedures in the OR (minimum of 2 subjects per investigator).

Group Type OTHER

Tube placement

Intervention Type DEVICE

Subjects will have tubes placed in the OR using the Tube Delivery System in all ears indicated for tube placement.

Interventions

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Iontophoresis & tube placement

Subjects will receive active Tymbion iontophoresis and will have tubes placed in-office using the Tube Delivery System in all ears indicated for tube placement.

Intervention Type COMBINATION_PRODUCT

Tube placement

Subjects will have tubes placed in the OR using the Tube Delivery System in all ears indicated for tube placement.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Males or females at least 6 months old through 12 years old at time of consent
2. Indication for tympanostomy tube insertion per Clinical Practice Guideline
3. Behavioral capacity and cooperative temperament to undergo an awake procedure, based on physician judgment (not applicable to OR Lead-In subjects)
4. Subject's parent/guardian and subject are able and willing to comply with the protocol and attend all study visits
5. Subject's parent/guardian and subject are able and willing to provide informed consent or assent as age appropriate

Exclusion Criteria

1. Significantly atrophic, retracted, bimeric, monomeric or atelectatic tympanic membrane
2. Perforated tympanic membrane
3. Otitis externa
4. Active or recent conditions of the tympanic membrane (eg, prior myringotomy with incomplete wound healing or re-epithelization)
5. Hemotympanum
6. Damaged/denuded skin in the auditory canal
7. Cerumen impaction resulting in a significant amount of cleaning required to visualize the tympanic membrane potentially causing abrasion or irritation to the external ear canal
8. Anatomy that precludes sufficient visualization of and access to the tympanic membrane
9. Anatomy that necessitates tympanostomy tube placement in the posterior half of the tympanic membrane
10. History of sensitivity or allergic reaction to lidocaine HCl, tetracaine, epinephrine, or any hypersensitivity to local anesthetics of the amide type, or any component of the anesthetic drug formulation (not applicable to OR Lead-In subjects)
11. Familial history of insensitivity to lidocaine or other local anesthetics of the amide type (eg, history of inadequate anesthesia with dental numbing agents). (not applicable to OR Lead-In subjects)
12. Electrically sensitive medical support systems (eg, pacemakers, defibrillators, cochlear implants)
13. Other conditions that would preclude performing the study procedure including iontophoresis system ear plug incompatibility.
14. Health conditions that, in the opinion of the investigator, would present undue risk to the subject, based on device/anesthetic drug product label warnings and precautions.
15. Subject is 4 years or older and not able to complete all baseline assessments. Subject is younger than 4 years and not able to complete all baseline assessments, not including audiometry.
Minimum Eligible Age

6 Months

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tusker Medical

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lawrence Lustig

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Locations

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California Head and Neck Specialists

Carlsbad, California, United States

Site Status

Sacramento ENT

Roseville, California, United States

Site Status

Camino Ear Nose & Throat Clinic

San Jose, California, United States

Site Status

Connecticut Children's Medical Center

Hartford, Connecticut, United States

Site Status

Yale School of Medicine, Section of Otolaryngology

New Haven, Connecticut, United States

Site Status

South Florida Pediatric Otolaryngology

Fort Lauderdale, Florida, United States

Site Status

Nemour's Children's Specialty Care

Jacksonville, Florida, United States

Site Status

Advanced ENT & Allergy

Louisville, Kentucky, United States

Site Status

Albany ENT & Allergy Services

Albany, New York, United States

Site Status

Columbia University Medical Center

New York, New York, United States

Site Status

Charlotte Ear Eye Nose & Throat Associates, PA

Charlotte, North Carolina, United States

Site Status

Specialty Physician Associates

Bethlehem, Pennsylvania, United States

Site Status

South Carolina Ear Nose and Throat

Lugoff, South Carolina, United States

Site Status

Carolina Ear Nose and Throat Clinic

Orangeburg, South Carolina, United States

Site Status

Ear Nose and Throat Specialists of Abilene

Abilene, Texas, United States

Site Status

Frisco ENT for Children

Frisco, Texas, United States

Site Status

Collin County ENT

Frisco, Texas, United States

Site Status

Ear Medical Group

San Antonio, Texas, United States

Site Status

British Columbia Children's Hospital

Vancouver, British Columbia, Canada

Site Status

Countries

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United States Canada

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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CPR007001

Identifier Type: -

Identifier Source: org_study_id

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