title: Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?
abstract: OBJECTIVE
  The effect of topical N-acetylcysteine (NAC) application was investigated on the healing of acute experimental tympanic membrane perforations.
  
  
  METHODS
  Twenty guinea pigs were used in this study. Under intraperitoneal ketamine anesthesia, incisional myringotomies were performed in the posterosuperior quadrant of the tympanic membranes with a straight otologic hook. The diameter of the perforations was approximately 2 mm. Perforations in both ears were treated with freshly prepared sponges soaked in either 0.1 ml 0.9% NaCl solution (10 control animals) or 0.6 mg/0.1 ml NAC (10 animals) for three consecutive days. All the tympanic membranes were examined by otomicroscopy on the third, fifth, seventh, and ninth days.
  
  
  RESULTS
  In the control group, all the perforations were completely closed at the end of nine days. During the same period, only 40% of the perforations were completely closed in the NAC group. The remaining ears exhibited otorrhea by the third day.
  
  
  CONCLUSIONS
  N-acetylcysteine may cause severe otorrhea in the healing process of tympanic membrane perforations. Further studies including histopathological examinations are required to elucidate this condition.
authors.affiliation: Department of Otolaryngology, Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey.
authors.forename: Arif
authors.initials: A
authors.lastname: Sanli
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eken
authors.forename: Cenk
authors.initials: C
authors.lastname: Evren
authors.forename: Günay
authors.initials: G
authors.lastname: Ateş
authors.forename: Mustafa
authors.initials: M
authors.lastname: Paksoy
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage / Q000009:adverse effects*; D000287:Administration, Topical; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D006168:Guinea Pigs; D010035:Otitis Media, Suppurative / Q000139:chemically induced* / Q000473:pathology; D012720:Severity of Illness Index; D018058:Tympanic Membrane Perforation / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000111:Acetylcysteine