Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?
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.
Sanli
Arif
A
Department of Otolaryngology, Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey.
Eken
Mehmet
M
Evren
Cenk
C
Ateş
Günay
G
Paksoy
Mustafa
M
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
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000111:Acetylcysteine