Management of Refractory Tympanostomy Tube Otorrhea with Ear Wicks

Abstract

Objectives: Report our experience with ear wicks for the treatment of chronic tympanostomy tube otorrhea, failing to improve with oral and/or topical antibiotics. Methods: Retrospective review of 7 children with tympanostomy tubes and recurrent otorrhea failing medical management in 2012 at a tertiary care center. We describe the outcomes of patients after wick placement and Ciprodex ear drops. Results: The average age of patients in this study is 30 months (21-48months). The average age of tympanostomy tube insertion was 17 months (8-32 months). All patients had Armstrong grommet tubes placed. Three patients found effusions during time of insertion. All children failed previous topical and/or oral antibiotic treatment. An ear wick was placed during the clinic visit, and ciprodex drops were continued. Wicks were removed in approximately one week. Culture results showed 4 patients had Methicillin-resistant Staphylococcus aureus and 3 had Pseudomonas aeruginosa. After wick placement, 7/7 (100%) patients’ otorrhea resolved. One patient had recurrent otorrhea at further follow-up visit. Conclusions: Tympanostomy tube placement is one of the most common surgical procedures in children. Refractory otorrhea continues to be a complication that has a negative effect on patient quality of life and remains a challenge to treat. It can be difficult to adequately deliver topical therapy to young children. Placement of an ear wick improves topical delivery to the ear and may eradicate otorrhea in patients who failed prior topical and oral antibiotics.