Phenylephrine and the prevention of postoperative tympanostomy tube obstruction.
OBJECTIVE
To determine the efficacy of phenylephrine hydrochloride, a topical vasoconstrictor, in preventing tympanostomy tube obstruction.


METHODS
Prospective, randomized, double-blind, controlled trial of patients undergoing myringotomy with tympanostomy tube insertion.


METHODS
Academic, tertiary referral medical center.


METHODS
Two hundred eight patients were enrolled in the study; 157 patients (310 ears) returned for postoperative evaluation.


METHODS
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.


METHODS
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).


CONCLUSIONS
The use of phenylephrine following tympanostomy tube insertion greatly reduces the incidence of tube obstruction.
Altman
J S
JS
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Mich, USA.
Haupert
M S
MS
Hamaker
R A
RA
Belenky
W M
WM
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000295:instrumentation*; D010034:Otitis Media with Effusion / Q000601:surgery*; D010656:Phenylephrine / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control*; D011475:Prosthesis Failure; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D000900:Anti-Bacterial Agents; D014662:Vasoconstrictor Agents; D010656:Phenylephrine