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A prospective study of infection following tympanostomy and tube insertion
Insights
Postoperative infection after middle ear ventilation tube surgery can be reduced. Antibiotic-steroid ear drops significantly lowered infection rates in a study of pediatric patients undergoing tympanostomy.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Infectious Disease
Background:
- Postoperative infection following middle ear ventilation tube surgery occurs in up to 15% of cases.
- This complication rate is considered unacceptably high for most surgical procedures.
Purpose of the Study:
- To evaluate the efficacy of prophylactic treatments in reducing postoperative infection rates after tympanostomy and tube surgery in children.
Main Methods:
- A prospective, controlled study involving 107 children undergoing tympanostomy and tube surgery.
- Participants were randomized into three groups: antibiotic-steroid otic drops, oral ampicillin, or no prophylactic treatment.
- Infections were monitored for four weeks post-surgery.
Main Results:
- The overall infection rate was 12%.
- Purulent otorrhea occurred in 18% of the untreated group, 13% of the ampicillin group, and 6% of the antibiotic-steroid otic drop group.
- Factors associated with increased infection risk included a history of otitis media and prior tube placement.
Conclusions:
- Prophylactic antibiotic-steroid otic drops significantly reduce the incidence of postoperative infection after middle ear ventilation tube surgery.
- Oral ampicillin showed a modest reduction in infection rates compared to no treatment.
- Patient history of otitis media and previous tube placement are risk factors for postoperative infection.
Abstract:
An incidence of postoperative infection of up to 15 percent has been reported following middle ear ventilation tube surgery. This rate of complication would be considered unacceptable following most other operative procedures. A controlled prospective study of 107 children undergoing tympanostomy and tube surgery over a 1-year period was undertaken. Subjects were randomly assigned to receive antibiotic-steroid otic drops at the time of surgery and for 1 week afterward, oral ampicillin for 24 hours preceding and 3 days following surgery, or no prophylactic treatment. The overall infection rate within four weeks of surgery was 12 percent. Purulent otorrhea occurred in 18 percent of those receiving no prophylactic treatment, in 13 percent receiving ampicillin, and in 6 percent receiving antibiotic-steroid otic drops. Postoperative infection was related to preoperative history of status otitis media and to previous placement of ventilation tubes.