Effects of ciprofloxacin-dexamethasone on myringotomy wound healing.
OBJECTIVE
To evaluate the effects of the ciprofloxacin-dexamethasone (CDX) combination ototopical treatment after myringotomy on tympanic membrane (TM) healing in ears with eustachian tube obstruction (ETO) and unobstructed ears.


METHODS
Prospective, randomized, masked, controlled.


METHODS
ETO was created in the left ear of 30 rats to induce a model of otitis media with effusion (OME). After 3 weeks, bilateral myringotomy was performed (day 0). Animals were randomized into three groups to receive no treatment or bilateral once daily ototopical treatment with balanced salt solution (BSS, vehicle) or CDX for 13 days. Bilateral otomicroscopy was performed on days 7, 14, and 28. On day 14, five randomly selected animals per group were humanely euthanized and the TM harvested for histology. Three additional rats provided normal negative control ears for histologic comparisons.


RESULTS
On day 14, TM perforation healing rates were 100% in all ears of untreated and BSS-treated animals, 89% (8/9) in CDX-treated obstructed ears, and 30% (3/10) in CDX-treated unobstructed ears (P < .05 vs. BSS). On day 28, 100% (5/5) of the CDX-treated unobstructed ears and 80% (4/5) of the CDX-treated obstructed ears were healed. Histology showed initial TM thickening postmyringotomy in all ears but no significant qualitative differences between groups on day 28.


CONCLUSIONS
Myringotomy healing was transiently modulated by treatment with CDX but proceeded normally after CDX discontinuation. This early modulation might enhance middle ear drainage and middle ear concentrations of CDX when tympanostomy tube surgery is performed in patients with active OME and ETO, thus potentially reducing otorrhea and preventing or treating infection. It would not be expected to increase the risk of premature tube extrusion or adversely affect normal healing of the TM after usual spontaneous extrusion.
Hebda
Patricia A
PA
Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Yuksel
Sancak
S
Dohar
Joseph E
JE
D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004338:Drug Combinations; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D008297:Male; D009225:Myringoplasty; D010034:Otitis Media with Effusion / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D051381:Rats; D017207:Rats, Sprague-Dawley; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D014945:Wound Healing / Q000187:drug effects*
D000890:Anti-Infective Agents; D004338:Drug Combinations; D005938:Glucocorticoids; D002939:Ciprofloxacin; D003907:Dexamethasone