Prevention of early otorrhea in ventilation tubes

Abstract

The incidence of early postoperative otorrhea after placement of ventilation tubes ranges from 12% to 40%. This prospective randomized study of 430 children, ages 6 months to 15 years, examined the efficacy of sulfacetamide/prednisolone otic drops used for 3 days postoperatively in reducing the incidence of otorrhea at 1 week after the placement of Donaldson tubes. Subjects were randomized into two groups--drops and no drops. Preoperative diagnosis and intraoperative findings were correlated with findings. The incidence of otorrhea among all patients was 11.9%. The use of sulfacetamide/prednisolone drops for 3 days after insertion of ventilation tubes failed to reduce the incidence of otorrhea in the overall study population. The drops did demonstrate a trend toward reducing the incidence of otorrhea in certain subpopulations, including children under 3 years of age, blood at the myringotomy site, and thick middle ear effusions. Subpopulations associated with a higher incidence of otorrhea were also identified.

Aseptic surgical technique and postgrommet otorrhoea

“…In this study, the patient discharge rate was 14.29% which is in keeping with other reports on postgrommet otorrhoea [2,5,9]. Four of the five ears which developed discharge had thick mucoid effusions at myringotomy, the remaining one having had a thin serous effusion (Fig.…”

Parent-Reported Otorrhea in Children with Tympanostomy Tubes: Incidence and Predictors

“…Previous studies on these associations often used univariable analyses or included a small selection of predictors [7], [12]–[14], [17], [18]. To account for dependencies between predictors, we have performed a multivariable analysis.…”

“…We selected candidate predictors based on their suggested or shown association with OM or TTO in the literature (see table 1 for definitions) [7]–[10], [12]–[15], [17], [18]. First, we assessed the relation between each of the candidate predictors and our main outcome (one or more episodes of TTO in the time period since tympanostomy tube placement).…”

Grommets in otitis media with effusion: the most frequent operation in children. But is it associated with significant complications?

“…A distinction should be made between early otorrhea, which appears within 2-4 weeks after the operation, and delayed otorrhea, which occurs several months postoperatively [40]. The prevalence of early otorrhea ranges from 10 to 20% [4,5,19,22,26,36,57,65,66,81], whereas delayed otorrhea seems to be more frequent, occurring in 26% of cases [36]. Other studies have reported even higher rates of otorrhea, up to 50% of cases within a 3-year observation period [41,42] and even 83% in a study on children up to 36 months old at the time of insertion.…”

“…The routine perioperative prophylactic use of local antibiotic ear drops flies in the face of evidence-based [19,66,81] A related meta-analysis found an 85% reduction of otorrhea when perioperative antibiotic drops were used [21], but the low incidence of this complication and the heterogeneity of the published studies prevented the authors from drawing a final conclusion; they therefore recommended the judicious use of these agents, with emphasis on those cases at higher risk of otorrhea, namely those with mucoid or purulent effusion. In terms of preventing biofilm formation, emphasis has been placed on the effect of a surface treatment of fluoroplastic grommets.…”