Otorrhea after insertion of silver oxide-impregnated silastic tympanostomytubes

Background: Silver oxide-impregnated tympanostomy tubes have been shown to decrease the incidence of postoperative otorrhea, but without a significant effect in the first postoperative week. Objective: To evaluate prospectively our results with silver oxide-impregna ted tympanostomy tubes and to identify factors associated with a higher inc idence of early postoperative otorrhea. Design: Prospective nonrandomized study. Setting: University referral center. Patients and Other Participants: Six hundred thirty patients with chronic o titis media with effusion or recurrent otitis media. Interventions: Silver oxide-impregnated Silastic tympanostomy tubes were in serted in 1254 ears. Subjects with mucoid or purulent effusions or blood at the myringotomy site at surgery were treated with topical antibiotic proph ylexis (sulfacetamide sodium-prednisolone acetate or neomycin sulfate-polym yxin B sulfate-hydrocortisone) for 5 days after tympanostomy tube placement . Main Outcome Measures: Incidence of otorrhea after tympanostomy tube insert ion at 1 week and 1, 3, 6, 9, and 12 months after surgery, Results: The overall incidence of postoperative otorrhea was 1.9%. The inci dence of otorrhea in the first postoperative week was 5.6%; the incidence o f otorrhea after the first postoperative week was 1.2% (P<.001). Within the first postoperative week, a significantly greater incidence of otorrhea wa s noted in patients younger than 3 years (7.8%), in patients with mucoid ef fusions at surgery (8.6%), and in patients younger than 3 years with mucoid effusions at surgery (15.2%). Conclusions: Silver oxide-impregnated tympanostomy tubes are associated wit h a low overall incidence of postoperative otorrhea. A significantly higher incidence of otorrhea is seen during the first postoperative week, compare d with the incidence after the first week. Patients with thick middle ear e ffusions and age younger than 3 years have a significantly greater incidenc e of early otorrhea after tympanostomy tube placement.