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Steroid Versus Antibiotic Drops in the Prevention of Postoperative Myringotomy Tube Complications

Sameer A Alvi1, Joel W Jones1, Paul Porter1

  • 11 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.

The Annals of Otology, Rhinology, and Laryngology
|May 30, 2018
PubMed

Insights

Topical antibiotic ear drops with or without steroids showed no significant difference in preventing tympanostomy tube otorrhea or obstruction in children. Patients with mucoid effusions are more prone to these complications, suggesting cost-effective drops are advisable.

Area of Science:

  • Otolaryngology
  • Pediatric Otology
  • Ophthalmology (Otic Preparations)

Background:

  • Tympanostomy tube insertion is a common pediatric otologic procedure.
  • Postoperative otorrhea and obstruction are potential complications following tube placement.
  • The role of perioperative topical antibiotic/steroid ear drops in preventing these complications requires clarification.

Purpose of the Study:

  • To compare the incidence of early postoperative otorrhea and obstruction in pediatric patients receiving tympanostomy tubes with perioperative antibiotic ear drops versus antibiotic-steroid ear drops.
  • To evaluate the impact of effusion type on postoperative outcomes.

Main Methods:

  • Retrospective chart review of pediatric patients undergoing myringotomy and tube placement.
  • Comparison of outcomes between two cohorts: ciprofloxacin/dexamethasone (antibiotic-steroid) and ofloxacin (antibiotic alone).
  • Statistical analysis to determine differences in otorrhea and obstruction rates.

Main Results:

  • No statistically significant difference in the rates of postoperative otorrhea (5.2% vs. 8.2%) or tube obstruction (6.0% vs. 5.2%) between the two treatment groups.
  • Patients with mucoid effusions at the time of surgery had a higher likelihood of experiencing otorrhea or obstruction (OR=2.23, P=.02).
  • No significant difference in effusion rates at tube placement between the cohorts.

Conclusions:

  • Perioperative antibiotic-steroid ear drops do not offer a significant advantage over antibiotic-alone drops in preventing early postoperative otorrhea or obstruction.
  • Mucoid effusions are a risk factor for developing otorrhea or obstruction after tympanostomy tube insertion.
  • Prescribing cost-effective topical therapies is recommended for preventing post-tympanostomy tube complications.
Abstract

Keywords:
antibiotic ear dropsotitis mediasteroid ear dropstympanostomy tube obstructiontympanostomy tube placement

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