Otorrhea and types of bacteria after tympanostomy tube insertion in children: gilded silver tubes versus silicon tubes

Otorrhea is the most common complication after tympanostomy tube insertions . In Germany there are currently two commonly used types of tympanostomy tu bes: silicon tubes (ST) and gilded silver tubes (GT). Previously published in vitro studies by Tajima uncovered a positive correlation between the sil icon concentration in culture fluid and the rate of growth of Staphylococcu s aureus. Our study retrospectively evaluates the types of bacteria and rat es of otorrhea after ST and GT insertions. The present study was undertaken to determine which of these tubes had a higher incidence of otorrhea and t hen whether silicon tubes stimulated the growth of certain types of bacteri a, such as Staphylococcus aureus. In all, 186 ST and 59 GT were placed in 2 45 ears of 144 children. Both ST and GT were separated into three groups: f irst insertion of a tympanostomy tube, second implantation and insertion of a tympanostomy tube in an infected ear in the course of a mastoidectomy. N o differences between ST and GT in causing otorrhea were found in the three groups. Nevertheless, ST in comparison to GT was associated with a higher incidence of infections with Pseudomonas aeruginosa. In contrast, a higher incidence of Staphylococcus aureus related to ST could not be proved. Twent y percent of the ears with mastoiditis were found to have Pseudomonas aerug inosa, but none of these ears implanted with a GT developed postoperative o torrhea. Our findings show that GT should be used when a ventilation tube i s used during a mastoidectomy. Further, it is tenable to implant only GT be cause post-operative otorrhea in many cases is caused by insufficient water protection and water is frequently polluted with Pseudomonas aeruginosa.