Management of the Draining Pressure Equalization Tube

Philomena Mufalli Behar and N. Wendell Todd

CHAPTER 36

Tympanostomy tube insertion is one of the most commonly performed surgical procedures in children. Otorrhea is a frequent complication of tympanostomy tubes, occurring in 6 to 68% some time after tube insertion.1-5 Persistent or recurrent otorrhea is reported in approximately 3 to 38% of patients.5'6 Otorrhea may occur during the immediate postoperative period, or later, and persist for weeks or months.

Measures useful in diminishing tympanostomy tube otor-rhea are widely discussed and debated among otolaryngologists. The safety and effectiveness of these measures are controversial. Factors considered, at least by some physicians, to decrease the incidence of postoperative tympanostomy tube otorrhea include control of environmental and behavioral risk factors for otitis media, antiseptic preparation of the ear during tympanostomy tube insertion, tube material, topical antibiotics at tube insertion, and perhaps for a few days later, and "water precautions" (i.e., keeping water out of the ear).

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