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Steroid Versus Antibiotic Drops in the Prevention of Postoperative Myringotomy Tube Complications.
Ann Otol Rhinol Laryngol 2018; 127(7):445-449AO

Abstract

OBJECTIVES

To determine the incidence of early postoperative tympanostomy tube insertion otorrhea and obstruction in pediatric patients receiving antibiotic ear drops with or without steroid perioperatively.

METHODS

A retrospective chart review was performed on patients who underwent outpatient myringotomy and tube placement. Patients from June 2013 to February 2014 received ciprofloxacin/dexamethasone perioperatively while patients from May 2014 to April 2015 received ofloxacin. Statistical analysis was performed to compare outcomes between the cohorts.

RESULTS

One hundred thirty-four patients received topical ciprofloxacin/dexamethasone, and 116 patients received topical ofloxacin. The rate of postoperative otorrhea was 5.2% for the ciprofloxacin/dexamethasone group and 8.2% for the ofloxacin group. Tube obstruction was seen in 6.0% of the ciprofloxacin/dexamethasone group and 5.2% in the ofloxacin group. Neither outcome had a statistically significant difference (P = .21 and .85, respectively). There was no difference in the rate of effusion at the time of tube placement between the 2 cohorts (P = .16), and this included subgroup analysis based on effusion type (mucoid, purulent, serous). Patients with a mucoid effusion at the time of surgery were more likely to experience otorrhea/obstruction than patients with dry ears (odds ratio = 2.23, P = .02).

CONCLUSION

No significant difference in the incidence of immediate postoperative tympanostomy tube otorrhea or obstruction was seen between the antibiotic-steroid and antibiotic alone cohorts, regardless of effusion type. Overall, patients with mucoid effusions are more likely to develop tube otorrhea or obstruction at follow-up. Cost-effective drops should be used when prescribing topical therapy to prevent complications after ear tubes.

Authors+Show Affiliations

1 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.1 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.1 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.2 Univerity of Kansas School of Medicine, Kansas City, Kansas, USA.1 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.1 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.1 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

29807438

Citation

Alvi, Sameer A., et al. "Steroid Versus Antibiotic Drops in the Prevention of Postoperative Myringotomy Tube Complications." The Annals of Otology, Rhinology, and Laryngology, vol. 127, no. 7, 2018, pp. 445-449.
Alvi SA, Jones JW, Porter P, et al. Steroid Versus Antibiotic Drops in the Prevention of Postoperative Myringotomy Tube Complications. Ann Otol Rhinol Laryngol. 2018;127(7):445-449.
Alvi, S. A., Jones, J. W., Porter, P., Perryman, M., Nelson, K., Francis, C. L., & Larsen, C. G. (2018). Steroid Versus Antibiotic Drops in the Prevention of Postoperative Myringotomy Tube Complications. The Annals of Otology, Rhinology, and Laryngology, 127(7), pp. 445-449. doi:10.1177/0003489418776669.
Alvi SA, et al. Steroid Versus Antibiotic Drops in the Prevention of Postoperative Myringotomy Tube Complications. Ann Otol Rhinol Laryngol. 2018;127(7):445-449. PubMed PMID: 29807438.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Steroid Versus Antibiotic Drops in the Prevention of Postoperative Myringotomy Tube Complications. AU - Alvi,Sameer A, AU - Jones,Joel W, AU - Porter,Paul, AU - Perryman,Mollie, AU - Nelson,Karen, AU - Francis,Carrie L, AU - Larsen,Christopher G, Y1 - 2018/05/28/ PY - 2018/5/29/pubmed PY - 2018/7/17/medline PY - 2018/5/30/entrez KW - antibiotic ear drops KW - otitis media KW - steroid ear drops KW - tympanostomy tube obstruction KW - tympanostomy tube placement SP - 445 EP - 449 JF - The Annals of otology, rhinology, and laryngology JO - Ann. Otol. Rhinol. Laryngol. VL - 127 IS - 7 N2 - OBJECTIVES: To determine the incidence of early postoperative tympanostomy tube insertion otorrhea and obstruction in pediatric patients receiving antibiotic ear drops with or without steroid perioperatively. METHODS: A retrospective chart review was performed on patients who underwent outpatient myringotomy and tube placement. Patients from June 2013 to February 2014 received ciprofloxacin/dexamethasone perioperatively while patients from May 2014 to April 2015 received ofloxacin. Statistical analysis was performed to compare outcomes between the cohorts. RESULTS: One hundred thirty-four patients received topical ciprofloxacin/dexamethasone, and 116 patients received topical ofloxacin. The rate of postoperative otorrhea was 5.2% for the ciprofloxacin/dexamethasone group and 8.2% for the ofloxacin group. Tube obstruction was seen in 6.0% of the ciprofloxacin/dexamethasone group and 5.2% in the ofloxacin group. Neither outcome had a statistically significant difference (P = .21 and .85, respectively). There was no difference in the rate of effusion at the time of tube placement between the 2 cohorts (P = .16), and this included subgroup analysis based on effusion type (mucoid, purulent, serous). Patients with a mucoid effusion at the time of surgery were more likely to experience otorrhea/obstruction than patients with dry ears (odds ratio = 2.23, P = .02). CONCLUSION: No significant difference in the incidence of immediate postoperative tympanostomy tube otorrhea or obstruction was seen between the antibiotic-steroid and antibiotic alone cohorts, regardless of effusion type. Overall, patients with mucoid effusions are more likely to develop tube otorrhea or obstruction at follow-up. Cost-effective drops should be used when prescribing topical therapy to prevent complications after ear tubes. SN - 1943-572X UR - https://www.unboundmedicine.com/medline/citation/29807438/Steroid_Versus_Antibiotic_Drops_in_the_Prevention_of_Postoperative_Myringotomy_Tube_Complications_ L2 - http://journals.sagepub.com/doi/full/10.1177/0003489418776669?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -