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Scientific Oral Presentations

Otology/Neurotology

Session: Scientific Oral Presentations 8 - Otology/Neurotology

The Effect of Intra-operative Ciprofloxacin vs Ciprofloxacin-Hydrocortisone Otic Drops on Tympanoplasty Healing and Hearing Outcomes

Tuesday, October 1, 2024
11:42 AM – 11:48 AM EDT
Location: MBCC, 231
Disclosure(s):
Maryam K. Aljneibi, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Marc K. Bassim, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Taim Akhal:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Quinolones, dexamethasone-quinolone, and neomycin-polymyxin-hydrocortisone otic drops are common preparations used in tympanoplasty practice. There is a paucity of recommendations on intraoperative tympanoplasty drops. This study aimed to compare the effect of intraoperative ciprofloxacin (CF) vs ciprofloxacin-hydrocortisone (CFH) drops on healing (residual perforation) and hearing (air-bone gap (ABG)) outcomes in tympanoplasty patients.

Methods: Tympanoplasty cases were retrospectively identified from electronic medical records. The patient characteristics and procedure details were extracted from each patient’s record. Intraoperative CFH drops were administered in surgeries from May 2021 until March 2022, and CF drops were used from March 2022 and onwards. Residual perforation was assessed via otoscopy. The latest available post-operative ABG was used to calculate the change in ABG (ΔABG = preoperative ABG – post-operative ABG).

Results: A total of 127 tympanoplasty procedures were analyzed; CFH drops were used in 86 procedures and CF drops were used in 41. A residual perforation was present in 16.5% of the CFH cases and in 10.3% of the CF cases (odds ratio = 0.58 [0.178, 1.891]) (p = 0.362). A binary regression model that adjusted for other study variables—gender, age, perforation location and size, preoperative ABG, laterality, the presence of an assisting resident, eustachian tube dilation, other operative findings/procedures (e.g. cholesteatoma, canaloplasty, OCR), surgery duration, revision surgery, type of prosthesis, graft, cartilage use and surgical view—yielded an odds ratio of 0.926 (p = 0.926). The mean improvement in ABG in the CF group (10.52 dB) was lower than the CFH group (11.07 dB) (mean difference = -0.557 [-5.440 , 4.325]) (p = 0.821), but did not achieve statistical significance. An automatic linear model analysis nominated the preoperative ABG, residual perforation, and graft variables as the top predictors of ABG improvement.

Conclusions: The Intraoperative use of CFH vs CF has little effect on healing and hearing outcomes of tympanoplasty surgery.

    Presenting Author(s)

  • Maryam K. Aljneibi, MD

    Otolaryngology resident
    Cleveland Clinic Abu Dhabi
    Abu Dhabi, Abu Dhabi, United Arab Emirates

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Marc K. Bassim, MD

    Section Head Otology and Neurotology
    Cleveland Clinic
    Cleveland, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Taim Akhal

    Student
    Royal College of Surgeons in Ireland: Medical University of Bahrain
    Abu Dhabi, Abu Dhabi, United Arab Emirates

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.