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Per-operative antibiotic/steroid prophylaxis of tympanostomy tube otorrhoea: chemical or mechanical effect?

Published online by Cambridge University Press:  29 June 2007

C. A. Shinkwin*
Affiliation:
Department of Otolaryngology, University Hospital, NottinghamLeicester, UK.
G. E. Murty
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, Leicester, UK.
R. Simo
Affiliation:
Department of Otolaryngology, University Hospital, NottinghamLeicester, UK.
N. S. Jones
Affiliation:
Department of Otolaryngology, University Hospital, NottinghamLeicester, UK.
*
Address for correspondence: Mr C. A. Shinkwin, F.R.C.S., Department of Otolaryngology, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH.

Abstract

The per-operative instillation of ototopical antibiotic/steroid drops reduces the incidence of early otorrhoea after tympanostomy tube insertion. Whether this is due to the chemical properties of the antibiotic/steroid or simply the mechanical instillation of fluid is unclear. In this paired matched study of 161 subjects Gentisone HC was shown to significantly reduce the otorrhoea rate compared to normal saline (1.24 per cent compared with 9.32 per cent, p<0.005, difference 8.07 per cent, 95 per cent confidence interval for difference 3.21 per cent to 12.93 per cent). Capillary viscosimetry proved Gentisone HC to be more viscous than normal saline. The benefits are due to Gentisone HC's chemical properties, and Gentisone HC rather than normal saline instillation per-operatively is recommended when tympanostomy tubes are inserted.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1996

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Footnotes

Presented to the Otorhinolaryngological Research Society, April 1994, Glasgow.

References

Baker, R. S., Chole, R. A. (1988) A randomized clinical trial of topical gentamicin after tympanostomy tube placement. Archives of Otolaryngology, Head and Neck Surgery 114: 755757.CrossRefGoogle ScholarPubMed
Baldwin, R. L., Aland, J. (1990) The effects of povidone iodine preparation on the incidence of post-tympanostomy otorrhoea. Otolaryngology – Head and Neck Surgery 102 (6): 631634.CrossRefGoogle Scholar
Balkany, T. J., Arenberg, I. K., Steenerson, R. L. (1986) Ventilation tube surgery and middle ear irrigation. Laryngoscope 96: 529532.CrossRefGoogle ScholarPubMed
Balkany, T. J., Barkin, R. M., Suzuki, B. H., Watson, W. J. (1983) A prospective study of infection following tympanostomy and tube insertion. American Journal of Otology 4: 288291.Google ScholarPubMed
Barford, C., Rosberg, J. (1980) Secretory otitis media: longterm observations after treatment with grommets. Archives of Otolaryngology, Head and Neck Surgery 106: 553556.CrossRefGoogle Scholar
Birck, H. G., Mravec, J. J. (1979) Myringotomy for middle ear effusions. Annals of Otology, Rhinology and Laryngology 85 (suppl. 25): 263267.CrossRefGoogle Scholar
Coates, H. L., Sashikumar, A. (1990) A prospective clinical trial of antibiotic/steroid ear drops and incidence of infection following ventilation tube insertion. Journal of the Otolaryngological Society of Australia 6: 212–21A.Google Scholar
Daly, L. G., Bourke, G. J., McGilvray, J. (1991) Confidence intervals and hypothesis tests. In Interpretation and Uses of Medical Statistics. 4th Edition. Blackwell Scientific Publications, London pp 130132.Google Scholar
Gates, G. A., Avery, C., Prihoda, T. J., Holt, G. R. (1986) Post-tympanostomy otorrhoea. Laryngoscope 96: 630634.CrossRefGoogle Scholar
Giebink, G. S., Daly, K., Buran, D. J., Satz, M., Ayre, T. (1992) Predictors for post-operative otorrhoea following tympanostomy tube insertion. Archives of Otolaryngology, Head and Neck Surgery 105: 161164.Google Scholar
Harlock, J. N., Coates, H. L. (1992) Single dose antibiotic/ steroid ear drop prophylaxis with ventilation tube insertion. Australian Journal of Otolaryngology 1: 3032.Google Scholar
Herzon, F. S. (1980) Tympanostomy tubes. Archives of Otolaryngology 106: 645647.CrossRefGoogle ScholarPubMed
Luxford, W. M., Sheehy, J. L. (1982) Myringotomy and ventilation tubes: a report of 1568 ears. Laryngoscope 92: 12931297.CrossRefGoogle Scholar
Meyerhoff, W. L., Morizono, T., Shaddock, L. C., Wright, C. G., Shea, D. A., Sikora, M. A. (1983) Tympanostomy tubes and otic drops. Laryngoscope 93: 10221027.CrossRefGoogle ScholarPubMed
Ramadan, H. H., Tarazi, T., Zaytoun, G. M. (1991) Use of prophylactic otic drops after tympanostomy tube insertion. Archives of Otolaryngology, Head and Neck Surgery 117: 537.CrossRefGoogle ScholarPubMed
Salam, M. A., Cable, H. R. (1993) The use of antibiotic/steroid ear drops to reduce post-operative otorrhoea and blockage of ventilation tubes. A prospective study. Journal of Laryngology and Otology 107: 188189.CrossRefGoogle ScholarPubMed
Slack, R. W. T., Gardner, J. M., Chatfield, C. (1987) Otorrhoea in children with middle ear ventilation tubes: a comparison of different types of tubes. Clinical Otolaryngology 12: 357360.CrossRefGoogle ScholarPubMed
Zacharia, M. W., Robson, A. K., Shinkwin, C. A. (1993) Single dose antibiotic/steroid drop prophylaxis with ventilation tube insertion. A follow-up study. Australian Journal of Otolaryngology 1 (3): 238240.Google Scholar