A randomized clinical trial of topical gentamicin after tympanostomy tube placement

Purulent otorrhea is the most common complication of tympanostomy with tube placement. Some authors report an incidence of over 30%. We have evaluated topical gentamicin solution for prophylaxis in a controlled, randomized, prospective clinical trial. Nine patients of the 102 in the study developed otorrhea in the first two postoperative weeks. All nine were in the control group of 46. The 56 patients receiving prophylactic gentamicin had no cases of purulent otorrhea. Several other characteristics of the patients and the procedures were examined as possible risk factors for otorrhea. None were statistically significant, but the younger patients had a higher rate of infection. We recognize the theoretical risk of ototoxicity, but conclude that instillation of topical gentamicin is an effective prophylactic technique for preventing purulent otorrhea after tympanostomy.