Preventing perioperative obstruction of tympanostomy tubes: a prospective trial of a simple method

The intraluminal obstruction of tympanostomy tubes by hemorrhage incurred in the perioperative period is not a rare problem. The exact frequency, however, is unknown and methods of prevention have not been studied. We prospectively investigated a method of unilaterally coating one grommet with antibiotic ointment in 128 children undergoing bilateral tympanostomy tube placement; the contralateral tube was not treated. We established the incidence of intraluminal obstruction by blood in untreated grommets to be 4.7%. The incidence of hemorrhagic obstruction of the coated tubes was less (2.3%) but did not achieve statistical significance (P less than 0.20). The technique of antibiotic ointment application to the tympanostomy tube at the time of surgery was not sufficiently efficacious to justify routine use.