Audit of middle-ear surgery outcomes in a tertiary referral Australian teaching hospital.

OBJECTIVE: This study aimed to audit middle-ear surgical procedures, provide a record of Australian experiences and allow comparisons with other published audits. METHOD: A retrospective continuous series audit was conducted on 274 patients who underwent tympanoplasty, mastoidectomy and stapedotomy surgery at Westmead Hospital, Sydney. All consecutive surgical procedures, performed by multiple operators at various stages of training but under the care of a single surgeon, were included. RESULTS: Graft uptake was 86.9 per cent in tympanoplasty. Well healed cavities were seen in 72 per cent of mastoidectomies. Although 42 per cent of the patients had one or more co-morbidities, this did not influence the outcome. Hearing improvement was dramatic in stapedotomy and minimally changed in mastoidectomy. Post-operative complications were minimal. CONCLUSION: All forms of middle-ear surgery were effective in achieving their surgical goals. Aural discharge and inflammatory diseases were well controlled with tympanoplasty and mastoid surgery.

Betadine has a ciliotoxic effect on ciliated human respiratory cells.

OBJECTIVE: This study investigated the effect of Betadine on ciliated human respiratory epithelial cells. METHODS: Epithelial cells from human sinonasal mucosa were cultured at the air-liquid interface. The cultures were tested with Hanks' balanced salt solution containing 10 mM HEPES (control), 100 µM ATP (positive control), 5 per cent Betadine or 10 per cent Betadine (clinical dose). Ciliary beat frequency was analysed using a high-speed camera on a computer imaging system. RESULTS: Undiluted 10 per cent Betadine (n = 6) decreased the proportion of actively beating cilia over 1 minute (p < 0.01). Ciliary beat frequency decreased from 11.15 ± 4.64 Hz to no detectable activity. The result was similar with 5 per cent Betadine (n = 7), with no significant difference compared with the 10 per cent solution findings. CONCLUSION: Betadine, at either 5 and 10 per cent, was ciliotoxic. Caution should be applied to the use of topical Betadine solution on the respiratory mucosal surface.