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Adv Otorhinolaryngol 2019 15;82:101-110. Epub 2019 Jan 15.

Many pharmaceuticals have ototoxicity (both cochlear and/or vestibular) as part of their adverse medication profile. The aminoglycoside class of antimicrobials has been especially well studied in this regard. Many questions remain unanswered as to how to best monitor and prevent this complication. Read More

Int J Pharm 2019 Mar 23;559:201-209. Epub 2019 Jan 23.

Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt. Electronic address:

Acute otitis media (AOM), an infection in the middle ear, is usually treated through systemic administration of antibiotics because the stratum corneum of the intact tympanic-membrane (TM) possesses low permeability that holds against the ototopical antibiotics use. Therefore, the objective of this work was to encapsulate levofloxacin (LFX) into polyethylene glycol 400 (PEG 400) decorated nanoliposomes (PNLs) as an approach for drug delivery through the intact tympanic-membrane. LFX loaded-PNLs were primed by ethanol injection technique. Read More

J Int Adv Otol 2019 Apr;15(1):22-27

Department of Otorhinolaryngology, Health Sciences University, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.

Objectives: Topical treatment is first choice in the treatment of uncomplicated chronic otitis media. It was intended to assess auditory and histopathological safety of ototopical use of mercurochrome solution in rats with induced tympanic membrane perforation.

Materials And Methods: The study was conducted on 21 female Wistar-Albino rats which were randomly assigned into 3 groups. Read More

Int J Pediatr Otorhinolaryngol 2018 Jul 16;110:110-113. Epub 2018 May 16.

University of Texas Health San Antonio, Department of Otolaryngology - Head and Neck Surgery, United States. Electronic address:

Objectives/introduction: Tympanostomy tube placement is the most common surgical procedure in the pediatric population with important financial implications to our healthcare institutions. The purpose of this study is to apply various cost models in different clinical environments to determine the most cost effective way to prescribe ear drops after tympanostomy tube insertion.

Methods: Two distinct practice models were designed: a Uniform Treatment Model and a Disease Specific Model. Read More

Can Commun Dis Rep 2017 Jul 6;43(7-8):150-153. Epub 2017 Jul 6.

Section of Infectious Diseases, Departments of Internal Medicine and Medical Microbiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB.

is a fungal pathogen that has recently emerged as a global threat to public health. It was first described in Japan in 2009 and has since been reported in 17 countries on five continents. This case report describes the first reported case of multidrug-resistant in Canada. Read More

Int J Pediatr Otorhinolaryngol 2018 Jun 24;109:36-39. Epub 2018 Mar 24.

Department of Otolaryngology - Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, USA; Department of Pediatrics, Lewis Katz School of Medicine at Temple University, USA. Electronic address:

Objective: To demonstrate the safety and effectiveness of topical 2% mupirocin ointment as an adjunctive therapy for tympanostomy tube otorrhea (TTO) caused by methicillin-resistant Staphylococcus aureus (MRSA).

Methods: We treated children with community-acquired MRSA TTO by aural suctioning and culture-directed systemic antibiotics (+/- ototopical drops) alone (control group) or with the addition of single 1 ml dose of mupirocin ointment applied to the tube and ear canal (mupirocin group). Patient age, laterality, response to treatment, associate hearing loss, duration of follow-up, and recurrence of infection by MRSA or by other organisms were compared. Read More

Otolaryngol Head Neck Surg 2018 05 13;158(5):923-929. Epub 2018 Mar 13.

1 Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA.

Objective Despite the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) otologic infections, choice of treatment remains controversial. Only fluoroquinolone-containing ototopical preparations are approved by the US Food and Drug Administration for middle ear application. Furthermore, American Academy of Otolaryngology-Head and Neck Surgery Foundation guidelines advocate ototopical monotherapy for both tympanostomy tube otorrhea and acute otitis externa. Read More

Otolaryngol Head Neck Surg 2018 05 20;158(5):917-922. Epub 2018 Feb 20.

1 Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Florida, Gainesville, Florida, USA.

Objective Ciprofloxacin + dexamethasone ear drops have been associated with higher rates of tympanic membrane perforations than ofloxacin. This was thought to be an effect of the steroid; however, ciprofloxacin (sans steroid) has been found to be more toxic to tympanic membrane fibroblasts than ofloxacin in vitro. This study aimed to compare the effect of these agents on tympanic membrane healing in vivo. Read More

Braz J Otorhinolaryngol 2018 Jul - Aug;84(4):441-447. Epub 2017 May 31.

Chonnam National University Medical School, Department of Otolaryngology, Gwangju, South Korea. Electronic address:

Introduction: Methicillin-resistant staphylococcus aureus is an emerging problem for the treatment of chronic suppurative otitis media, and also for pediatric tympanostomy tube otorrhea. To date, there are no effective topical antibiotic drugs to treat methicillin-resistant staphylococcus aureus otorrhea.

Objective: In this study, we evaluated the ototoxicity of topical KR-12-a2 solution on the cochlea when it is applied topically in the middle ear of guinea pigs. Read More

Int J Pharm 2017 Apr 7;522(1-2):157-164. Epub 2017 Mar 7.

Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Egypt.

The aim of this research was to encapsulate ciprofloxacin, a broad spectrum fluoroquinolone antibiotic, into Span 60 based nano-elastic vesicles, nano-spanlastics, for accomplishing improved non invasive trans-tympanic delivery, providing means for ototopical treatment of acute otitis media (AOM). To achieve this purpose, ciprofloxacin-loaded nano-spanlastics were prepared by thin film hydration (TFH) technique, using several non-ionic edge activators (EAs) according to full factorial design (3). The investigation of the effect of formulation variables on nano-spanlastic characteristics and selection of the optimum formula were performed using Design-Expert software. Read More

J Int Adv Otol 2017 Apr 7;13(1):105-109. Epub 2016 Nov 7.

Department of Otorhinolaryngology, Erciyes University School of Medicine, Kayseri, Turkey.

Objective: In patients with a perforated tympanic membrane, topically administered medication reaches the middle ear and thus creates a risk of ototoxicity. The aim of the present study was to evaluate the possible ototoxic effect of the antifungal medication nystatin when administered to the rat middle ear cavity.

Materials And Methods: Three groups (negative control, positive control, and study groups), each containing eight rats, were formed. Read More

Otolaryngol Head Neck Surg 2017 02 3;156(2):341-349. Epub 2016 Oct 3.

1 Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA.

Objective To assess collagen and α-tubulin levels of mouse tympanic membrane fibroblasts treated with quinolone and aminoglycoside antibiotics at concentrations found in eardrops. Study Design Prospective controlled cell culture study. Setting Academic tertiary medical center. Read More

Otol Neurotol 2016 09;37(8):1049-54

Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina.

Objectives: To forecast national Medicaid prescription volumes for common ototopical antibiotics, and correlate prescription volumes with internet user search interest using Google Trends (GT).

Study Design: National United States Medicaid prescription and GT user search database analysis.

Methods: Quarterly national Medicaid summary drug utilization data and weekly GT search engine data for ciprofloxacin-dexamethasone (CD), ofloxacin (OF), and Cortisporin (CS) ototopicals were obtained from January 2008 to July 2014. Read More

J Laryngol Otol 2016 Jan 20;130(1):2-7. Epub 2015 Nov 20.

Department of Otorhinolaryngology,Betsi Cadwaladr University Health Board,Rhyl,Wales,UK.

Objective: This systematic review aimed to establish that quinolones are as effective as aminoglycosides when used to treat chronic suppurative otitis media.

Method: The review included good quality, randomised, controlled trials on human subjects, published in English, that compared topical aminoglycosides with topical quinolones for the treatment of chronic suppurative otitis media.

Results: Nine trials met the criteria. Read More

Am J Otolaryngol 2015 Nov-Dec;36(6):814-9. Epub 2015 Jul 7.

Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, Durham, NC.

Objective: To determine if providers prescribe more affordable topical antibacterial therapy for patients who are economically disadvantaged or come from economically disadvantaged communities.

Study Design: Prescription drug database review.

Setting: Large academic hospital network. Read More

Pediatr Infect Dis J 2015 Apr;34(4):355-60

From the *Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; †Department of Otorhinolaryngology, University Medical Center Utrecht, Utrecht, The Netherlands; ‡Virology Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands; §Department of Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; and ¶ENT Clinical Trials Programme, Ear Institute, University College London, London, United Kingdom.

Background: Acute tympanostomy-tube otorrhea is a common sequela in children with tympanostomy tubes. Acute tympanostomy-tube otorrhea is generally a symptom of an acute middle ear infection, whereby middle ear fluid drains through the tube. The widespread use of pneumococcal conjugate vaccination (PCV) has changed the bacterial prevalence in the upper respiratory tract of children, but its impact on bacterial and viral pathogens causing acute tympanostomy-tube otorrhea is yet unknown. Read More

JAMA Otolaryngol Head Neck Surg 2015 Feb;141(2):148-53

Department of Otolaryngology, University of Florida College of Medicine, Gainesville.

Importance: Tympanostomy tube (TT) biofilm formation may lead to sequelae.

Objective: To determine whether the acute pathogen Haemophilus influenzae promotes TT attachment and biofilm formation by the chronic pathogen Staphylococcus aureus.

Design And Setting: Controlled, in vitro microbiological study at an academic research laboratory using TTs treated with 0 (untreated), 10, or 3000 µg/mL ciprofloxacin or ethylene oxide and TTs with and without prior H influenzae exposure. Read More

Int J Pharm 2014 Sep 24;472(1-2):304-14. Epub 2014 Jun 24.

Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El Aini Street, Cairo 11562, Egypt.

Ciprofloxacin is a synthetic fluoroquinolone antibiotic that has been used for systemic treatment of otitis media in adults. It was approved for topical treatment of otorrhea in children with tympanostomy tubes. The aim of this work was to enhance the local non-invasive delivery of ciprofloxacin to the middle ear across an intact tympanic membrane (TM) in an attempt to treat acute otitis media (AOM) ototopically. Read More

J Laryngol Otol 2013 Nov 29;127(11):1143-4. Epub 2013 Oct 29.

Department of Otology and Laryngology, Medical University of Vienna, Austria.

Introduction: The exact aetiology of congenital cholesteatoma, the less common form of this destructive disease, is still under debate.

Case Report: A two-year-old boy was referred to paediatric otolaryngology with persistent, bloody, left-sided otorrhoea refractory to oral and ototopical antibiotics. Prior to its onset at age 16 months, all ear examinations on the affected side were normal. Read More

Expert Opin Pharmacother 2013 Dec 7;14(17):2399-405. Epub 2013 Oct 7.

University of Texas Southwestern Medical Center, Department of Otolaryngology , 5323 Harry Hines Blvd, Dallas, TX 75390 , USA

Introduction: Ciprofloxacin 0.3% with dexamethasone 0.1% (ciprofloxacin/dexamethasone) is an ototopical preparation for acute otitis externa, otorrhea with tympanostomy tubes, and is frequently used to treat chronic suppurative otitis media (CSOM). Read More

Pediatr Emerg Care 2013 Feb;29(2):203-8

Inova Fairfax Hospital for Children, Pediatric Residency Program, Falls Church, VA 22042-3300, USA.

Introduction: Posttympanostomy tube otorrhea also known as acute otitis media with tympanostomy tubes (AOMT) occurs in 15% to 80% of children with tympanostomy tubes. Its management is fairly standardized among pediatric ear, nose, and throat (ENT) physicians owing to recommendations published by the American Academy of Otolaryngology-Head and Neck Surgery. Pediatric emergency medicine (EM) physicians have no such guidelines. Read More

Can Fam Physician 2012 Nov;58(11):1222-4

BC Children's Hospital, Department of Pediatrics, Room K4-226, Ambulatory Care Bldg, 4480 Oak St, Vancouver, BC V6H 3V4.

Question: In the summer months I see many children with uncomplicated acute otitis externa (AOE). I am aware of the multiple ototopical preparations. Which is the best first-line agent to treat AOE, and is there a role for an oral antibiotic?

Answer: There are no specific Canadian guidelines for the management of AOE. Read More

Biomaterials 2013 Jan 9;34(4):1281-8. Epub 2012 Nov 9.

Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.

We have developed a drug delivery system for prolonged trans-tympanic antibiotic delivery from a single dose administration. Increased permeability to ciprofloxacin of the intact tympanic membrane (TM) was achieved by chemical permeation enhancers (CPEs--bupivacaine, limonene, sodium dodecyl sulfate); this was also seen by CPEs contained within a hydrogel (poloxamer 407) to maintain the formulation at the TM. The CPE-hydrogel formulation had minimal effects on auditory thresholds and tissue response in vivo. Read More

Int J Pediatr Otorhinolaryngol 2012 Dec 25;76(12):1795-8. Epub 2012 Sep 25.

Division of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Objectives: To describe our experience and clinical outcomes with the management of pediatric tympanostomy tube otorrhea secondary to methicillin-resistant Staphylococcus aureus (MRSA).

Methods: Retrospective review of pediatric patients (age <18) diagnosed with culture-positive MRSA tympanostomy tube otorrhea.

Results: MRSA positive ear cultures in the presence of tympanostomy tubes were identified in 41 patients (6. Read More

Laryngoscope 2012 Nov 10;122(11):2529-32. Epub 2012 Sep 10.

Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.

Objectives/hypothesis: Although contraindicated, neomycin otic preparations may be administered to children with nonintact tympanic membranes (TMs), such as tympanostomy tubes or TM perforations. The goal of this study was to assess the magnitude of neomycin exposure in children with nonintact TMs.

Study Design: Retrospective drug utilization study. Read More

Int J Pediatr Otorhinolaryngol 2012 Feb 22;76(2):179-82. Epub 2011 Dec 22.

Department of Otolaryngology, University of Florida, Gainesville, FL 32610, USA.

Objective: Tympanostomy tube otorrhea (TTO), caused by the presence of pathogenic bacteria in the middle ear, is the most common complication of TT insertion. No studies have described a reproducible animal model of TTO. We aimed to develop a rat model of TTO which, in turn, could be used to assay the levels of TNF-α and IL-1β through the course of the infection. Read More

Otolaryngol Head Neck Surg 2011 Dec 22;145(6):1022-4. Epub 2011 Aug 22.

Department of Pediatric Otolaryngology-Head and Neck Surgery, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.

In this prospective controlled animal study, the authors investigated the potential ototoxic effects of ototopical application of nystatin through a tympanostomy tube, using their established chinchilla animal model. Each of the 10 animals used had ventilation tubes inserted in both ears; 1 ear was randomly assigned to receive nystatin suspension, whereas the other ear did not receive any medication, serving as control. Distortion product otoacoustic emissions (DPOAEs) were measured in each animal before application of nystatin and at 45 and 60 days after application. Read More

Otolaryngol Head Neck Surg 2011 Dec 16;145(6):1025-9. Epub 2011 Aug 16.

Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas 66160, USA.

Objectives: Posttympanostomy tube otorrhea (PTTO) results in significant health care cost and decreased satisfaction with care. The authors reviewed PTTO failing initial ototopical and/or oral antibiotic therapy and microbiology/susceptibility data from cultures.

Study Design: Case series with chart review. Read More

Otolaryngol Head Neck Surg 2011 Sep 29;145(3):414-7. Epub 2011 Apr 29.

Division of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Objectives. Determine the influence of the acute otitis externa clinical practice guideline on clinical care. Study Design. Read More

Otolaryngol Head Neck Surg 2011 Jun 18;144(6):891-3. Epub 2011 Feb 18.

Department of Head & Neck Surgery, Kaiser Permanente Medical Center, Oakland, CA 94611, USA.

Objective: Tragal pumping is the practice of pushing on the tragus to raise pressure in the external auditory canal. This is a study to determine if tragal pumping improves middle ear penetration of ototopical medications via a patent pressure equalization tube.

Study Design: Prospective, randomized controlled trial. Read More

Otolaryngol Head Neck Surg 2011 Sep;145(3):470-5

Department of Otolaryngology, University of Florida, Gainesville, FL, USA.

Objectives: Tympanostomy tube (TT) biofilm formation may lead to refractory otorrhea and occlusion. Biofilms are commonly composed of multiple microbial species. One species may promote or inhibit biofilm formation by other species. Read More

Otolaryngol Head Neck Surg 2011 Mar 24;144(3):419-26. Epub 2011 Jan 24.

University of Connecticut Health Center, Division of Otolaryngology-Head & Neck Surgery, Farmington, Connecticut 06030, USA.

Objective: To determine whether mupirocin (440 µg/mL) and vancomycin otic drops (25 mg/mL) show evidence of ototoxicity in CBA/J mice immediately following a 7-day course of daily intratympanic (IT) injections and 1 month following treatment.

Study Design: Nonrandomized controlled trial.

Setting: Academic hospital laboratory. Read More

Eur J Gen Pract 2011 Sep 8;17(3):167-70. Epub 2011 Apr 8.

Kogi State Specialist Hospital, Lokoja, Nigeria.

Background: Ototopical self-medication is a common practice in Nigeria.

Objective: The aim of the study was to establish the proportion of patients with otological problems that practice ototopical self-medication.

Methods: A 12-week cross-sectional study of all the new patients attending the general outpatient (also called family medicine (FM)) and ear, nose and throat (ENT) departments of a Nigerian specialist hospital was carried out. Read More

Laryngoscope 2011 May 24;121(5):1067-71. Epub 2011 Mar 24.

Department of Otolaryngology, University of Florida College of Medicine, Gainesville, Florida 32610-0264, USA.

Objectives: Single doses of different ototopical antibiotic preparations (OAPs) have been shown to have an unequal reduction of post tympanostomy tube otorrhea (PTTO). Microbial biofilm formation on the tympanostomy tube (TT) has been implicated as one cause of PTTO. The goal of this study was to determine if TT exposure to a single dose of OAP reduces biofilm formation by Pseudomonas aeruginosa. Read More

Laryngoscope 2010 Oct;120(10):2083-8

Department of Otolaryngology HNS, University of Texas Southwestern Medical Center, Dallas UT Southwestern, Dallas, Texas 75390-9035, USA.

Objectives: To assess the feasibility of delivering ofloxacin across the intact tympanic membrane; to compare middle ear bioavailability of ofloxacin after otic and systemic administrations; to determine distribution of otically delivered ofloxacin to other tissues.

Study Design: A prospective, controlled animal study.

Methods: Rats underwent surgery wherein the middle ear cavity was opened and filled with saline. Read More

Arch Otolaryngol Head Neck Surg 2010 May;136(5):481-7

Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-9035, USA.

Objective: To investigate possible ototoxic effects of topical azithromycin (AZ) in the guinea pig.

Design: A prospective, controlled animal study.

Setting: The University of Texas Southwestern Medical Center at Dallas. Read More

Acta Otolaryngol 2010 Aug;130(8):897-903

Department of Biotechnology, Hoseo University, Asan, Chungnam-Do, Korea.

Conclusion: Di-K19Hc is a promising new ototopical antibiotic for treatment of middle ear infections associated with antibiotic-resistant bacteria.

Objectives: Di-K19Hc was previously shown to exert profound antimicrobial activity against a variety of antibiotic-resistant bacteria and fungi. In this study, we evaluated the potential use of di-K19Hc as a topical agent for the treatment of otitis media (OM) caused by a variety of microbial pathogens including bacteria resistant to conventional antibiotics. Read More

Acta Otorrinolaringol Esp 2009 Jul-Aug;60(4):227-33. Epub 2009 Jun 11.

Servicio de ORL, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España.

Introduction And Objectives: To evaluate the optimal treatment for diffuse acute otitis externa (DAOE) by means of a new staging system based on clinical and otoscopic findings.

Methods: Monitoring of otitis cases diagnosed at our Centre over the last 21 months (n=1,026), taking into account those who returned for a second visit, either via the emergency service or with a prior appointment. Staging of otitis externa by degree of obstruction of the external auditory canal (EAC): under 25% (type I, n=174); between 25% and 75% (type II; n=277); over 75% (type III; n=359); total obstruction due to organized oedema (type IV; n=216). Read More

Otol Neurotol 2009 Apr;30(3):339-43

Department of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.

Introduction: Antibiotic resistance has complicated the management of the draining ear. In this study, we examine the factors predisposing to resistance, as well as the role culture played in the management of these patients.

Materials And Methods: A retrospective chart review was performed on all patients with a complaint of otorrhea during a 3-year period. Read More

Arch Otolaryngol Head Neck Surg 2009 Mar;135(3):238-41

Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Connecticut Health Center, Farmington, CT 06030, USA.

Objective: To test for ototoxicity after prolonged ototopical fluoroquinolone use in the middle ear space using a murine model.

Design: Nonrandomized controlled trial.

Subjects: Twelve CBA/J mice. Read More

Curr Med Res Opin 2009 Feb;25(2):287-91

Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

Objective: To compare treatment failure rates for the two major acute otitis externa (AOE) pathogens, Pseudomonas aeruginosa and Staphylococcus aureus, by topical therapy with ciprofloxacin 0.3%/dexamethasone 0.1% (CDex) or neomycin 0. Read More

Int J Pediatr Otorhinolaryngol 2009 Feb 19;73(2):301-5. Epub 2008 Dec 19.

Haydarpasa Numune Education and Research Hospital Istanbul, Istanbul, Turkey.

Objective: To examine the potential of ototopical ciprofloxacin-dexamethasone (CDX) to delay the closure of myringotomy perforation and to evaluate its effect on inflammation.

Study Design: Prospective, randomized, and controlled.

Methods: Effusion is obtained in the right middle ear of 24 rats by blocking nasopharyngeal opening of eustachian tube by fibrin glue. Read More

Expert Opin Pharmacother 2008 Dec;9(17):3129-35

UT Southwestern Medical Center, Department of Otolaryngology, 5323 Harry Hines Boulevard, Dallas, TX 75390-9035, USA.

The American Academy of Otolaryngology-Head and Neck Surgery has recommended that, where possible, infections of the external auditory canal and middle ear be treated with topical preparations. The advantages of topical therapy include i) excellent efficacy; ii) decreased risk of systemic side effects; iii) less likelihood of selecting for resistant strains of microorganisms; and iv) lack of potential for ototoxicity. One advantage of topical therapy arises as a consequence of a very high concentration of antibiotic in topical preparations reaching the site of infection. Read More

Int J Pediatr Otorhinolaryngol 2008 Dec 8;72(12):1815-21. Epub 2008 Oct 8.

Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea; Research Center for Resistant Cells, Chosun University, Gwangju, South Korea.

Background And Objective: With the increased use of ototopical ciprofloxacin solution, newly evolved bacterial fluoroquinolone resistance has also become more of a problem. The emergence of ciprofloxacin-resistant Pseudomonas aeruginosa (CRPA) has created a new therapeutic challenge in otology. We evaluated the ototoxicity of topical fortified piperacillin-tazobactam solution by performing experiments in young male albino guinea pigs (weight, 250-300 g each). Read More

Otol Neurotol 2008 Aug;29(5):676-8

Department of Otorhinolaryngology, Juntendo University School of Medicine, Tokyo, Japan.

Objective: Methicillin-resistant Staphylococcus aureus (MRSA) otorrhea has become an increasing problem with regard to infection through the tympanic membrane perforation and postsurgical infection. In particular, dry ear, at the preoperative stage, is considered to be a crucial factor in surgery. We evaluated how to control MRSA otorrhea before and after ear surgery. Read More

N Z Med J 2008 Jan 25;121(1268):U2898. Epub 2008 Jan 25.

Department of Paediatric Otolaryngology/Head and Neck Surgery, Starship Children's Hospital, Auckland, New Zealand.

Aim: There is increasing awareness of the potential for ototoxicity with the administration of aminoglycoside eardrops in the presence of a non-intact tympanic membrane, whether that is due to a perforation or due to the presence of a patent ventilating tube. Expert panels in the USA, Canada, UK, and Australia have all advocated the preferential use of non-ototoxic topical antibiotics for the discharging middle ear and/or mastoid cavity. The advent of non-ototoxic fluoroquinolone eardrops provides the first real opportunity to prescribe topical therapy in accordance with such guidelines. Read More

Int J Pediatr Otorhinolaryngol 2008 Jan 8;72(1):69-72. Epub 2007 Nov 8.

University of Miami/Jackson Memorial Hospital, Department of Otolaryngology, Miami, FL 33136, USA.

Objective: To evaluate the ability of surfactants to increase the penetration of ototopicals through tympanostomy tubes (TT).

Methods: An in vitro model was used to test the penetration of ototopicals with and without two surfactants (docusate sodium and beractant) through fluoroplastic and titanium TTs. The model was created by placing a TT through a perforation (myringotomy) in a model of the tympanic membrane (silastic sheet) fixed between the ends of two 1 mL syringes. Read More

Laryngoscope 2007 Oct;117(10):1819-24

Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA.

Objective: Examine how ototopical medications affect biofilms on fluoroplastic tympanostomy tubes.

Study Design: In vitro comparison of different ototopical medications against a clinical isolate of Pseudomonas aeruginosa biofilm on tympanostomy tubes treated for 5, 10, 14, and 21 days.

Methods: Under sterile conditions 21 tympanostomy tubes were cut in half. Read More

Otolaryngol Clin North Am 2007 Jun;40(3):669-83, xi

The Otology Group of Vanderbilt, Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Medical Center East S. Tower 7209, 1215 21st Avenue South, Nashville, TN 37232-5555, USA.

Various topical preparations are widely used for treating external otitis, acute otitis media with perforation, post-tympanostomy tube otorrhea, and chronic suppurative otitis media. Solutions and suspensions that enter the middle ear through a perforated tympanic membrane can reach the inner ear by crossing through the round window membrane. The safety of various components of otic solutions used in this way, particularly aminoglycosides, corticosteroids, solvents, and preservatives, has been questioned in light of their ototoxic potential. Read More

Laryngoscope 2007 Mar;117(3):522-8

Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.

Objective: To evaluate the effects of the ciprofloxacin-dexamethasone (CDX) combination ototopical treatment after myringotomy on tympanic membrane (TM) healing in ears with eustachian tube obstruction (ETO) and unobstructed ears.

Study Design: Prospective, randomized, masked, controlled.

Methods: ETO was created in the left ear of 30 rats to induce a model of otitis media with effusion (OME). Read More