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Preoperative topical ofloxacin solution for tympanoplasty: a randomized, controlled study
Michael C F Tong1, Virgil Yue, Peter K M Ku
1Division of Otorhinolaryngology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territory, Hong Kong, People's Republic of China.
Summary
Preoperative ototopical ofloxacin eardrops effectively eradicated middle ear pathogens in patients undergoing tympanoplasty. However, this treatment did not improve surgical graft success rates.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Surgical Outcomes
Background:
- Chronic suppurative otitis media (CSOM) poses challenges for surgical success.
- Eradicating middle ear pathogens preoperatively is crucial for improving outcomes in tympanoplasty.
Purpose of the Study:
- To evaluate the efficacy of preoperative ototopical ofloxacin eardrops in eliminating middle ear pathogens.
- To determine if ofloxacin treatment improves the success rate of Type I tympanoplasty (myringoplasty).
Main Methods:
- A single-blind, randomized controlled study was conducted with 101 patients with CSOM undergoing tympanoplasty.
- Patients were assigned to three groups: two received different durations of ofloxacin eardrops preoperatively, and one control group received no treatment.
- Outcomes were assessed by preoperative/perioperative bacteriology and tympanic membrane integrity at 8 weeks post-surgery.
Main Results:
- Ofloxacin treatment significantly reduced preoperative and perioperative bacterial cultures compared to the control group (p < 0.001).
- No significant difference was observed in the success rates of tympanoplasty (intact tympanic membrane) among the three groups.
- A higher rate of positive preoperative bacteriology was found in surgical failures compared to successful procedures (67% vs. 21%, p < 0.001).
Conclusions:
- Preoperative ototopical ofloxacin effectively eradicates bacterial flora in the middle ear.
- The study did not find evidence that preoperative ofloxacin eardrop use improves tympanoplasty graft success rates.