Thomas R. Collins is a freelance medical writer based in Florida.
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October 2021Discontinued Favorite Products
Here are a few products that have been discontinued in recent years, along with details on how the otolaryngology community adapted:
Product: Laser-Shield II laser safe endotracheal tube
What Physicians Liked: Smooth surface, soft touch, flexibility
How Physicians Adapted: Physicians used a stiffer, rough tube and advocated for manufacture of a new tube by another company.
Product: Netterville pre-carved Silastic implants
What Physicians Liked: A ridge at the bottom fit easily into a base for further carving, and the shape made for easier use during procedures.
How Physicians Adapted: Physicians learned to carve the ridge out of a brick-like block of material and used more time during procedures to carve out the implants.
Product: Aura XP KTP laser
What Physicians Liked: Familiarity and ease of use; this was a core working tool for laryngologists.
How Physicians Adapted: With the laser itself still available to use, laryngologists found fibers for it through medical equipment rental companies.
Product: Cymetra injectable material for vocal fold augmentation
What Physicians Liked: Texture and injectability
How Physicians Adapted: Physicians switched to other materials more commonly used in the cosmetics sphere.
Anatomy of an Alternative Product
When Andrew Georgilis, president of Cincinnati-based Bryan Medical, went to conferences several years ago, he would hear something over and over in the exhibit hall when he asked otolaryngologists what they wanted: “Make us an endotracheal tube.” The tube they had liked the most had been discontinued.
Finally, he decided to give it a go. The result was a silver lining to what was otherwise a disappointing fact of life in otolaryngology: Products that physicians like and that contribute to good patient outcomes are discontinued with no available replacement, but sometimes a new product can emerge.
Georgilis’ company initially worked on a new tube, and although the first lab testing went well, the final testing in porcine models failed. He created new prototypes based on advice from otolaryngologists and ran them past six focus groups to get feedback.
Aaron Friedman, MD, associate professor of clinical otolaryngology, head and neck surgery at the University of Cincinnati in Ohio, showed Georgilis a paper he had helped research on the ideal characteristics of a laser-protected endotracheal tube. Based on the paper’s results, the traits most prized in a tube were flexibility, surface smoothness, and a tight seal.
The newly developed Tenax tube was approved in the fall of 2020 and is currently in use at 60 centers. “The new tube works quite well, although it is expensive comparative to tubes we use in our practice,” said Jonathan Bock, MD, professor of otolaryngology–head and neck surgery at the Medical College of Wisconsin in Milwaukee.
Albert Merati, MD, chief of laryngology at the University of Washington in Seattle, sees the new tube as an illustration of what can happen when physicians work with manufacturers on products needed for patient care, he said. “Otolaryngology is a small field with deep knowledge, so speak up on products you need when you have the chance.”