Predictors for postoperative otorrhea following tympanostomy tube insertion.
This controlled prospective study was designed to identify predictors for postoperative otorrhea among 157 children with chronic otitis media with effusion undergoing myringotomy and tympanostomy tube placement (intubation). Ear canal disinfection with 70% alcohol or povidone-iodine did not significantly alter ear canal or middle ear effusion bacteriology, or the frequency of otorrhea during the first 7 days after surgery. However, the risk of otorrhea on the second postoperative day was significantly increased by the presence of a bacterial pathogen in the ear canal (relative risk, 2.4), or in the middle ear effusion (relative risk, 1.9), and the presence of inflamed middle ear mucosa at surgery (relative risk, 1.7) after controlling for age, preoperative antibiotics, and postoperative ototopical cortisporin treatment. The use of systemic antimicrobial treatment in children with inflamed middle ear mucosa at surgery or whose ear canal or middle ear effusion cultures are positive for bacterial pathogens might reduce the incidence of post-operative otorrhea in children undergoing intubation for chronic otitis media with effusion.
Giebink
G S
GS
Otitis Media Research Center, University of Minnesota School of Medicine, Minneapolis.
Daly
K
K
Buran
D J
DJ
Satz
M
M
Ayre
T
T
D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004203:Disinfection; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects / Q000379:methods*; D015999:Multivariate Analysis; D010034:Otitis Media with Effusion / Q000382:microbiology / Q000601:surgery*; D010035:Otitis Media, Suppurative / Q000517:prevention & control*; D011182:Postoperative Care; D011241:Prednisone / Q000627:therapeutic use; D011300:Preoperative Care; D011446:Prospective Studies; D012044:Regression Analysis; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D011241:Prednisone