The effects of povidone-iodine preparation on the incidence of post-tympanostomy otorrhea

Abstract

Persistent otorrhea after tympanostomy tube placement in children is a common complication. Previous reports have suggested that bacteria present within the ear canal may be the cause of postoperative drainage. Preparation of the ear canal with povidone-iodine solutions has been recommended to decrease these infections. A prospective study evaluating the efficacy of povidone-iodine ear canal preparation before myringotomy and tube placement was performed in 111 children (220 ears) with documented chronic otitis media with effusion. One ear in each patient was prepared with povidone-iodine. The contralateral ear in each child was used as control. Postoperative otorrhea developed in seven (6.3%) of the treated ears within 14 days, compared to eleven (10%) of the ears in the control group. The difference was not statistically significant (p greater than 0.05). Purulent or mucoid middle ear effusions and edematous or granular middle ear mucosa were associated with a significantly higher incidence of postoperative otorrhea (p less than 0.05). This study suggests that postoperative otorrhea is generally a consequence of preoperative middle ear condition rather than contamination from the external canal. Antimicrobial therapy should be considered when purulent effusion or granulation tissue is seen.