· Successful use of various topical anesthesia would also accommodate for various patient allergies

· Rapid procedure time; tube placement achieved in mostly a single pass in 84.4% of all studied cases; completed in two instrument passes in 98.2% of the studied cases (Truitt et al., 2021) Average placement time was 4 minutes and 53 seconds (Truitt et al., 2021).

· Decreased recovery time; 94.3% of children studied were classified as calm and/or no inappropriate crying upon being reunited with parents (Truitt et al., 2021).

· Can be successfully performed on awake child, when immobilized with use of protective restraint in younger children and optional restraint with older compliant children; Clinicians reported placement procedure was “tolerated acceptably” by the pediatric patients (Truitt et al., 2021).

· Patents could opt to be present during procedure to assist with calming and distracting their child, at discretion of otolaryngologist; this occurred in 66.8% of the cases studied (Truitt et al., 2021).

· Decreased cost and scheduling inconveniences in this office alternative opposed to surgery in an Operating Room (Truitt et al., 2021).

· No dietary restriction required prior to procedure (Truitt et al., 2021).

· Potential for procedure to have limited coverage by insurance if patient has to go to out of network clinics, or if newer procedure is not approved by all insurance companies.

· Learning curve for providers of this skill; newer procedure, and historically “much of clinical practice is guided by shared experience” (Issacson, 2020).

· Questionable tolerance; evaluation of the child’s tolerance did not include feedback from the parents or older verbal children, but was determined by clinician (Truitt et al., 2021).

· Procedure may fail and required standard intervention under general anesthesia with cases of anatomical challenges or patient movement (Truitt et al., 2021).

· Adverse events include: tube extrusion and tube dislocation during placement if patient is not properly restrained (Truitt et al., 2021).

· Other risks (that are also standard of all ear tubes): clogging, lost inside middle ear, limited duration of function, infection, persistent perforation, retention (Issacson, 2020).

· Incomplete evidence due to study limitations below: (Truitt et al., 2021)

      A-Not tested in children between 2-5 years old.
      
      B-Investigator excluded children with developmental delays, bleeding risks, or other conditions they decided placed patient at greater risk.

      C-Study excluded children who had previous ear tubes when they were age 6months-2 years.

       D-Does not account for long term use; study listed follow up data from 3-10 weeks post op, but not any further

My pursuit of knowledge will help me in gathering and storing information to make well-informed decisions.

2. Responsibility – Executing:

My dedication and ownership to my commitments will help me deliver high quality outcomes.

3. Analytical - Strategic Thinking

My critical thinking will help me assist with planning, provide clarity, and determine what the team needs to help us be successful.

4. Consistency - Executing

My desire for fairness and justice will help set predictable routines and clear boundaries.

5. Realtor - Relationship Building

My authenticity in relationships built on mutual trust will help others feel valued

(Gallup, n.d., 2023).

Isaacson G. (2020). Tympanostomy Tubes-A Visual Guide for the Young Otolaryngologist. Ear, nose, & throat journal, 99(1_suppl), 8S–14S. https://doi.org/10.1177/0145561320929885

Preceptis Medical (2019). Hummingbird Tts Product Animation. YouTube. Retrieved January 31, 2023, from https://youtu.be/RIFYx2M4xIk.

Spaw, M., & Camacho, M. (2022). Tympanostomy Tube. In StatPearls. StatPearls Publishing. Spaw, M., & Camacho, M. (Update 2022). Tympanostomy Tube. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK565858/

Truitt, T. O., Kosko, J. R., Nimmons, G. L., Raisen, J., Skovlund, S. M., Rimell, F., & Cofer, S. A. (2021). In-office insertion tympanostomy tubes in children using single-pass device. Laryngoscope investigative otolaryngology, 6(2), 325–331. https://doi.org/10.1002/lio2.533

Their take charge demeanor will help the team get moving and achieve our goals without delay. Their desire to implement change swiftly will balance out my desire to investigate all potential outcomes before making a decision.

2. Matthew - Maximizer - Influencing

Their ability to see and highlight a person's individual strengths will help the team function at its highest potential, since all members will feel valued for their unique contributions.

3. Daisy - Developer - Relationship Building

Their ability to see potential in others will complement the ability of the maximizer. If someone is struggling, they will be able to help them experience success.

4. Fernando - Focus - Executing

Their goal driven mentality will help them prioritize actions and keep the group on track to improve efficiency.

5. Sheila - Strategic - Strategic Thinking

Their ability to quickly find relevant information and the best route through a problem will help the team pursue a path to success.

(Gallup, n.d., 2023).

In pediatric patients with chronic ear infections, it can be difficult to navigate and process sensory input when everything they hear is muffled. They may feel constantly off balance due to these ear infections causing a buildup of fluid behind their eardrum. Frequent Acute Otitis Media can even be associated with hearing loss, speech delays, or gross motor delays in infants as they are learning to speak and walk. Having various treatments available is helpful in their treatment and prevention of long term problems. Parents who might otherwise decline surgical intervention due to perceived and actual risks will now have a solution that is more aligned with their treatment goals. 95.1% of parents studied agreed an alternative treatment was important to them, and 97.5% stated they would recommend the Hummingbird TTS procedure to other parents (Truitt et al., 2021).

That said, more studying of this device is necessary before it can be championed as a full replacement for the standard intervention. Performance of a Randomized Control Trial comparing the Hummingbird TTS to the standard method of placing ear tubes and addressing the current limitation of the study, as addressed in the Cons section of this investigation, would improve the study validity in a more diverse pediatric population.