Prophylactic Tobramycin Drops After Tympanostomy Tube Placement

Abdussalam Mohamed Jahan

doi:10.11648/j.ijo.20180401.12

Abstract

Tympanostomy tube insertion remains one of the most commonly performed surgeries in ENT practice. Post-operative infections remain one of the common complications after surgeries. Topical antibiotic ear drops are used to reduce the risk of this complication. The aim of this study was to assess the role of antibiotic ear drops (Tobramycin) in prevention of post-operative infection. A randomized controlled trial was done on 84 patients complaining of bilateral secretory otitis media, were operated using ventilation tube insertion. All patients were randomly allocated into two groups. The first group (group A) was the intervention group, in which all patients were given local tobramycin ear drops for five days post operatively to decrease otorrhea. The other group (group B) was the control group and no ear drops were prescribed post operatively. All patients in both groups were followed up to 14 days post operatively. A statistically significant decrease was observed in the incidence of post tympanostomy otorrhea and infections between the treatment group (group A = 7.1%), and the control group (group B = 14.2 %) (P<0.05). To conclude, antibiotic ear drops should be prescribed to all patients who are undergoing tympanostomy tube insertion. A 5-day course post operatively with tobramycin local drops is recommended.

Highlights

Insertion of tympanostomy tubes is one of the most common surgical procedures performed on children worldwide
Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy
Children younger than 7 years of age are at increased risk of otitis media, because of their immature immune systems and poor function of the Eustachian tube

Summary

Introduction

Insertion of tympanostomy tubes is one of the most common surgical procedures performed on children worldwide. The tympanostomy tube, which is approximately 1/20th of an inch in width, is placed in the child’s eardrum (tympanic membrane) to ventilate the middle ear space [1], [2]. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. All of these conditions are encompassed by the term otitis media (middle ear inflammation) [3]. When children require surgery for otitis media with effusion (OME), insertion of tympanostomy tubes is the preferred initial procedure, with candidacy dependent primarily on hearing status, associated symptoms, and the child’s developmental risk [5], [6]

Objectives

Methods

Results

Conclusion