ABSTRACT
OBJECTIVE: To determine the efficacy of phenylephrine hydrochloride, a topical vasoconstrictor, in preventing tympanostomy tube obstruction. DESIGN: Prospective, randomized, double-blind, controlled trial of patients undergoing myringotomy with tympanostomy tube insertion. SETTING: Academic, tertiary referral medical center. PATIENTS: Two hundred eight patients were enrolled in the study; 157 patients (310 ears) returned for postoperative evaluation. INTERVENTIONS: Myringotomy with tympanostomy tube insertion was performed in all ears: 139 control ears received ototopical antibiotics and 171 treatment ears received ototopical antibiotics plus topical phenylephrine. MAIN OUTCOME MEASURE: Postoperative tympanostomy tube obstruction. RESULTS: The overall incidence of tympanostomy tube obstruction was 5.2%: 8.6% in the control group and 2.3% in the treatment group. The treatment group demonstrated an odds ratio of 0.25 (95% confidence interval, 0.08-0.78; P= .02). CONCLUSION: The use of phenylephrine following tympanostomy tube insertion greatly reduces the incidence of tube obstruction.
Subject(s)
Middle Ear Ventilation/instrumentation , Otitis Media with Effusion/surgery , Phenylephrine/administration & dosage , Postoperative Complications/prevention & control , Vasoconstrictor Agents/administration & dosage , Adolescent , Adult , Anti-Bacterial Agents/administration & dosage , Child , Child, Preschool , Drug Therapy, Combination , Female , Humans , Infant , Male , Prosthesis FailureABSTRACT
A high jugular bulb is not an uncommon otologic anomaly. It may be noted as an incidental finding on physical exam, middle ear surgery, or computed tomography of the temporal bones. Frequently the patient is asymptomatic, but a high jugular bulb can occasionally cause tinnitus or conductive hearing loss. The case of a seven-year-old black male with unilateral conductive hearing loss secondary to a high jugular bulb is presented. The diagnosis, differential diagnosis, and management of a conductive hearing loss associated with a high jugular bulb are discussed.
Subject(s)
Ear, Middle/abnormalities , Hearing Loss, Conductive/diagnosis , Hearing Loss, Conductive/etiology , Hearing Loss/etiology , Child , Diagnosis, Differential , Ear, Middle/surgery , Humans , Male , TympanoplastyABSTRACT
A case of a 62-year-old man with a large mediastinal mass who had undergone aortocoronary bypass grafting 17 years earlier is presented. Computed tomography showed a 13-cm extrinsic cystic mass believed to represent a pericardial cyst or teratoma. Intraoperatively, the patient was noted to have an aneurysm of his right coronary artery bypass graft. We were able to find 4 other cases seen in this manner.