Saline irrigation in the prevention of otorrhea after tympanostomy tube placement

Objectives: Comparison of intraoperative saline irrigation to otic drops in the prevention of postoperative otorrhea in children with middle ear effus ion undergoing bilateral myringotomy with ventilation tubes. Study Design: This study was designed as a blinded, controlled, prospective ly randomized trial. Methods: Study children were randomly assigned to receive either otic drops for 3 days postoperatively or saline irrigation of the middle ear space at the time of myringotomy, Only children with effusion present at the time o f surgery were included. All children were evaluated for drainage 7 to 14 d ays postoperatively, and the degree of drainage was graded from 0 to 4. Results: Of the 84 patients entered into the study, 62 patients were eligib le for data analysis (16 failed follow-up, 6 records mere lost). Of the pat ients who completed the study, not all had bilateral effusions, resulting i n 111 ears for inclusion in the study, Fifty-two ears underwent irrigation, and 10 were noted to have otorrhea (19.2%). Fifty-nine ears received otic drops, resulting in 21 ears with otorrhea (35.6%). Evaluating the degree of otorrhea with a five-point Leichert scale, the average score per ear was 0 .42 for the saline irrigation group and 1.07 for the control group. The rat e and degree of drainage were both statistically reduced in the saline irri gation group (P < .05). Conclusions: Using middle ear irrigation at the time of tympanostomy may be more effective than antibiotic drops in preventing postoperative otorrhea.