Chymotrypsin: A useful adjunct to the management of “GLUE EARS”

Secretory Otitis Media

“…In our in vitro studies (Gessert et al 1960) and some recent clinical reports (Litton & McCabe 1962, Bouche et al 1960, DeBain, Fabre, Siardet & Laccourreye'1960, it was suggested that an a-chymotrypsin solution' instilled into the middle ear at the time of myringotomy might be effective in breaking down the complex protein-bound carbohydrates which appear to cause the high viscosity of the secretions. Although it is doubtful that this lysis can occur in the short time available during myringotomy or tonsil and adenoid surgery, the clinical reports are enthusiastic, and this form of therapy for mucopurulent ears should be evaluated under controlled conditions.…”

Seromucinous otitis media and its sequelae

“…undergoing tonsillectomy and adenoidectomy were found to have middleear effusions at myringotomy (Malcomson, 1963). Litton and McCabe (1962) found 263 children to be deaf out of 9,543 examined and of these 116 had middle ear effusions. Hoople (1950) reported a 20 per cent increase in the frequency of the condition since the advent of antibiotics.…”

Myringotomy, α-Chymotrypsin and Reverse Politzerization for “Glue” Ears

“…These failures were attributed to Eustachian blockage, and it therefore appeared necessary to aim treatment not only at Removal of glue from the middle ear but also from the tube itself. Litton and McCabe (1962) had already demonstrated theemcacy of _a_-Chymotrypsin in reducing the viscosity of the effusion in glue ears, and it was decided to investigate the effect of myringotomy, a-Chymotrypsin instillation and reverse politzerization in the management of this condition. It was hoped that by driving air and a-Chymotrypsin down the tube in a reverse direction any glue therein might be dispersed.…”