Alvi Sameer A, Jones Joel W, Porter Paul, Perryman Mollie, Nelson Karen, Francis Carrie L, Larsen Christopher G
1 Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA.
2 Univerity of Kansas School of Medicine, Kansas City, Kansas, USA.
Ann Otol Rhinol Laryngol. 2018 Jul;127(7):445-449. doi: 10.1177/0003489418776669. Epub 2018 May 28.
To determine the incidence of early postoperative tympanostomy tube insertion otorrhea and obstruction in pediatric patients receiving antibiotic ear drops with or without steroid perioperatively.
A retrospective chart review was performed on patients who underwent outpatient myringotomy and tube placement. Patients from June 2013 to February 2014 received ciprofloxacin/dexamethasone perioperatively while patients from May 2014 to April 2015 received ofloxacin. Statistical analysis was performed to compare outcomes between the cohorts.
One hundred thirty-four patients received topical ciprofloxacin/dexamethasone, and 116 patients received topical ofloxacin. The rate of postoperative otorrhea was 5.2% for the ciprofloxacin/dexamethasone group and 8.2% for the ofloxacin group. Tube obstruction was seen in 6.0% of the ciprofloxacin/dexamethasone group and 5.2% in the ofloxacin group. Neither outcome had a statistically significant difference ( P = .21 and .85, respectively). There was no difference in the rate of effusion at the time of tube placement between the 2 cohorts ( P = .16), and this included subgroup analysis based on effusion type (mucoid, purulent, serous). Patients with a mucoid effusion at the time of surgery were more likely to experience otorrhea/obstruction than patients with dry ears (odds ratio = 2.23, P = .02).
No significant difference in the incidence of immediate postoperative tympanostomy tube otorrhea or obstruction was seen between the antibiotic-steroid and antibiotic alone cohorts, regardless of effusion type. Overall, patients with mucoid effusions are more likely to develop tube otorrhea or obstruction at follow-up. Cost-effective drops should be used when prescribing topical therapy to prevent complications after ear tubes.
确定围手术期接受或未接受类固醇的抗生素耳滴剂治疗的儿科患者术后早期鼓膜置管术后耳漏和堵塞的发生率。
对接受门诊鼓膜切开置管术的患者进行回顾性病历审查。2013年6月至2014年2月的患者围手术期接受环丙沙星/地塞米松治疗，而2014年5月至2015年4月的患者接受氧氟沙星治疗。进行统计分析以比较两组之间的结果。
134例患者接受局部环丙沙星/地塞米松治疗，116例患者接受局部氧氟沙星治疗。环丙沙星/地塞米松组术后耳漏发生率为5.2%，氧氟沙星组为8.2%。环丙沙星/地塞米松组6.0%出现置管堵塞，氧氟沙星组为5.2%。两种结果均无统计学显著差异（P分别为0.21和0.85）。两组在置管时的积液发生率无差异（P = 0.16），这包括基于积液类型（黏液性、脓性、浆液性）的亚组分析。手术时出现黏液性积液的患者比耳干的患者更易发生耳漏/堵塞（优势比 = 2.23，P = 0.02）。
无论积液类型如何，抗生素-类固醇组和仅使用抗生素组之间术后早期鼓膜置管术后耳漏或堵塞的发生率均无显著差异。总体而言，黏液性积液患者在随访中更易发生置管后耳漏或堵塞。在开具局部治疗药物以预防耳管置入后并发症时，应使用具有成本效益的滴剂。
