title: The rationale for preventive treatments for early post-tympanostomy tube otorrhea in persistent otitis media with effusion.
abstract: Some studies have shown that post-tympanostomy tube otorrhea (PTTO) is a common complication after tympanostomy tube insertion. There are wide range of controversies about the incidence of PTTO and different methods of preventive treatment. The aim of this study was to determine the incidence of early PTTO in persistent otitis media with effusion in our centers. We also investigated the effect of preventive treatments on the incidence of early PTTO in children with persistent otitis media with effusion. This multi-central study comprised 536 ears belonging to children with otitis media and effusion for at least 3 months, referred for complications arising from post-tympanostomy tube insertion. The patients were randomly divided into three treatment and control groups. In the first group of patients, the middle ear cavity was irrigated with isotonic saline after myringotomy. The second group received oral amoxicillin three times a day for 7 days postoperatively. The third group had similar treatment as the second group, in addition to topical ciprofloxacin drop, 4 drops three times a day for 3 days after operation. The control group did not undergo any treatment. Early post-tympanostomy tube otorrhea was detected in 6 ears (1.1 %), including 3 (2.2 %) from the control group and 3 (2.3 %) from the first group. There was no statistically significant difference in early PTTO between integrated treatment groups and control group (P = 0.111). As the total rate of early post-tympanostomy tube otorrhea was very low, there was no significant difference between the 3 treatment groups and control group. Our study did not support the routine use of preventive therapy. A period of at least 3 months watchful waiting before tympanostomy tube insertion may help reduce the incidence of PTTO.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Faramarzi
authors.affiliation: The Department of Vice Chancellor for Research and Technology, Center for Development of Clinical Studies, Namazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Sareh
authors.initials: S
authors.lastname: Roosta
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Shiraz University of Medical Sciences, Shiraz, Iran. shishehgar@sums.ac.ir.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Shishegar
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Hamedan University of Medical Sciences, Hamadan, Iran.
authors.forename: Rohollah
authors.initials: R
authors.lastname: Abbasi
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Atighechi
mesh_terms: D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008876:Middle Ear Ventilation / Q000009:adverse effects* / Q000379:methods; D010034:Otitis Media with Effusion / Q000601:surgery*; D010035:Otitis Media, Suppurative / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011184:Postoperative Period; D019736:Prostheses and Implants / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D000658:Amoxicillin
keywords: Otitis media with effusion; Otorrhea; Tympanostomy tube