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- Title
Outcomes of Mastoidectomy With Antibiotic Catheter Irrigation for Patients With Draining Ventilation Tubes.
- Authors
Jones, Joel W.; Ballard, Daniel P.; Hillman, Todd A.; Chen, Douglas A.
- Abstract
Objectives: To evaluate the effectiveness of mastoidectomy with antibiotic catheter irrigation in patients with chronic tympanostomy tube otorrhea. Methods: A chart review of adult and pediatric patients with persistent tympanostomy tube otorrhea who had failed outpatient medical management and underwent mastoidectomy with placement of a temporary indwelling catheter for antibiotic instillation was performed. Patients were retrospectively followed for recurrent drainage after 2 months and outcomes were categorized as resolution (0-1 episodes of otorrhea or otitis media with effusion during follow-up), improvement (2-3 episodes), or continued episodic (>3 episodes). Results: There were 22 patients and 23 operated ears. Median age was 46 years (interquartile range, IQR = 29-65). The median duration of otorrhea from referral was 5.5 months (IQR = 2.8-12). Following surgery, 14 ears had resolution of drainage, 6 had improvement, and 3 had episodic. The observed percentage of resolved/improved ears (87%) was significant (P =.0005, 95% CI = 67.9%-95.5%). Median follow-up time was 25 months (IQR = 12-59). Pre and postoperative pure tone averages improved (difference of medians = −3.3 dB, P =.02) with no significant difference in word recognition scores (P =.68). Methicillin-resistant Staphylococcus aureus was the most common isolated microbe while no growth was most frequently noted on intraoperative cultures. Conclusions: Mastoidectomy with antibiotic catheter irrigation may be an effective surgical strategy, and single stage alternative to intravenous antibiotics, for select patients with persistent tube otorrhea who have failed topical and oral antibiotics.
- Subjects
ANTIBIOTICS; MASTOIDECTOMY; CONFIDENCE intervals; TYMPANIC membrane perforation; CHRONIC diseases; ORAL drug administration; RETROSPECTIVE studies; ACQUISITION of data; POSTOPERATIVE care; ANTIBIOTIC prophylaxis; TREATMENT effectiveness; MIDDLE ear ventilation; MEDICAL records; DESCRIPTIVE statistics; CATHETERIZATION; LONGITUDINAL method; OTITIS media
- Publication
ENT: Ear, Nose & Throat Journal, 2023, Vol 102, Issue 10, p673
- ISSN
0145-5613
- Publication type
Article
- DOI
10.1177/01455613211025742