Post-tympanostomy tube otorrhea: a meta-analysis.
BACKGROUND
Post-tympanostomy tube otorrhea is the most common complication of tympanostomy tube placement. The incidence of this problem varies from 3.4% to 74%. Trials that study post-tympanostomy tube otorrhea may involve valid randomization "by patient" or "by ear." In an attempt to define "best practice," we conduct a meta-analysis to quantify the benefit of using topical prophylactic antibiotic drops in the postoperative period. We then compare our findings with previous results found in the literature.


METHODS
We selected randomized studies for which antibiotic drops had been used for at least 48 hours after tympanostomy tube insertion. Nine studies, 3 "by ear" and 6 "by patient," met our inclusion criteria. The odds ratio and 95% confidence intervals were calculated for each to conduct the meta-analysis.


RESULTS
Overall, prophylaxis appears to be effective at reducing the incidence of post-tympanostomy tube otorrhea. The odds ratios for all studies were less than 1.0. However, none of the 3 "by ear" studies and only 3 of the 6 "by patient" studies were statistically significant. The mean odds ratio was 52%, suggesting that prophylaxis may reduce the incidence of post-tympanostomy tube otorrhea by half.


CONCLUSIONS
This meta-analysis suggests that routine post-tympanostomy tube prophylaxis is beneficial, but this finding is dependent on selection criteria used.


METHODS
A-1a.
Hochman
Jordan
J
Department of Otolaryngology, University of Manitoba, GB421-820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada.
Blakley
Brian
B
Abdoh
Ahmed
A
Aleid
Hazim
H
D002558:Cerebrospinal Fluid Otorrhea / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008876:Middle Ear Ventilation / Q000009:adverse effects* / Q000295:instrumentation; D011183:Postoperative Complications; D012307:Risk Factors