Myringotomy Tube Materials: Bacterial Adhesion and Infection

Abstract

Postoperative infection after placement of myringotomy tubes is common. Surgeons and manufacturers of surgical devices have frequently substituted one material for another in middle ear prostheses without analyzing the interaction of material and infection. Implant material attributes are reviewed. Scanning electron micrographs are presented that demonstrate characteristic surface differences between materials and between the same material of different manufacturers. A preliminary clinical controlled study of the covariance of purulence with silicone vs fluorocarbon tubes demonstrates statistically significant differences. The implications of this information are discussed.

Investigation of surface changes in different types of ventilation tubes using scanning electron microscopy and correlation of findings with clinical follow-up

“…They showed that fluoroplastic tubes were more robust to bacterial adhesion and contamination and that the silicon material is more prone to infection [21,22].…”

Infections associated with indwelling devices: infections related to extravascular devices

“…Minimizing operative time and tissue trauma are of obvious importance. Certain materials used to make medical devices may predispose to infection because they provide more favorable substrates for pathogens (27). Cement used to hold artificial joints in place, methylmethacrylate, has inhibitory action against polymorphonuclear cell chemotaxis and phagocytosis (43,46,47).…”

The use of piperacillin–tazobactam coated tympanostomy tubes against ciprofloxacin-resistant Pseudomonas biofilm formation: An in vitro study

“…Bacterial biofilm formation has been implicated in a high rate of persistent otorrhea after tympanostomy tube insertion [8][9][10]. An ideal tympanostomy tube material would be one that is well tolerated and resists bacterial adhesion.…”

“…It has been suggested that the tube material may be an important factor in the development of otorrhea. Karlan et al [9] have demonstrated a significant reduction in the rate of otorrhea with the use of fluoroplastic tubes as compared with silicone tympanostomy tubes. Silver ions inhibit the growth of Staphylococcus, Streptococcus, Escherichia coli, and Pseudomonas [11].…”