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Updated: Aug 10, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Phenylephrine and the prevention of postoperative tympanostomy tube obstruction
J S Altman1, M S Haupert, R A Hamaker
1Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Mich, USA.
Objective:
To determine the efficacy of phenylephrine hydrochloride, a topical vasoconstrictor, in preventing tympanostomy tube obstruction.
Design:
Prospective, randomized, double-blind, controlled trial of patients undergoing myringotomy with tympanostomy tube insertion.
Setting:
Academic, tertiary referral medical center.
Patients:
Two hundred eight patients were enrolled in the study; 157 patients (310 ears) returned for postoperative evaluation.
Interventions:
Myringotomy with tympanostomy tube insertion was performed in all ears: 139 control ears received ototopical antibiotics and 171 treatment ears received ototopical antibiotics plus topical phenylephrine.
Main Outcome Measure:
Postoperative tympanostomy tube obstruction.
Results:
The overall incidence of tympanostomy tube obstruction was 5.2%: 8.6% in the control group and 2.3% in the treatment group. The treatment group demonstrated an odds ratio of 0.25 (95% confidence interval, 0.08-0.78; P= .02).
Conclusion:
The use of phenylephrine following tympanostomy tube insertion greatly reduces the incidence of tube obstruction.
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