Antibiotic ear drops after tympanostomy tube insertion. Do they reduce postoperative otorrhea?

ABSTRACT

Post-operative otorrhea [POO] is the most common complication of tympanostomy tube [TT] insertion. Many otolaryngologists used to use prophylactic antibiotic ear drops to minimize the risk of POO. This study was designed to evaluate the value of prophylactic use of ear drops in decreasing POO. A total of 200 TTs were inserted in 100 children suffering from a clinically and audiologically confirmed chronic otitis media with effusion [OME]. Four drops of a solution consisting of polymyxin B sulfate, neomycin sulfate, sulfonamide and hydrocortisone were placed in the right ear after TT insertion. The left ear served as a control in all patients Fifty patients received drops only once after the surgery [group A] while the other 50 patients [group B] continued to use drops t.d.s for 3days. In group A, POO occurred only in 6 percent in right ears compared to 20 percent in the control left ears, a difference that was statistically significant [P <0.05]. This was the case also in group B where POO occurred in 6 percent and 22 percent in right and left ears, respectively [P < 0.05]. No difference was noted in POO incidence between ears receiving ear drops once [6 percent] and those continued a 3-day course [6 percent]. POO in left control ears showed a higher incidence when middle ear effusion was mucoid [28.3 percent] than when it was thin or absent [10 percent and 17.6 percent, respectively]. The difference between POO from mucoid effusion ears and those of thin effusion was statistically significant [P < 0.05]. It can be concluded that the use of ear drops once post- operatively reduces the incidence of POO with no remarkable difference from a 3-days course. Middle ears with mucoid effusion show higher incidence of POO than those with serous effusion