The Effectiveness of Antibiotic Ear Drops Versus No Intervention for Prevention of Ventilation Tube Otorrhoea and Obstruction

Background Middle ear ventilation tubes (MEVTs) are frequently used to treat recurrent acute otitis media and conductive hearing loss from chronic otitis media with effusion. Despite conflicting evidence for its efficacy, MEVT insertion remains one of the most common surgical procedures performed in children. Two common complications, ventilation tube otorrhoea (VTO) and ventilation tube blockage (VTB), can occur following surgery. Complication rates reported in previous systematic reviews range from 9% to 54% for otorrhoea and 10%–14% for obstruction. Objective To determine the effectiveness of antibiotic eardrops in preventing clinically significant postoperative otorrhoea and obstruction following grommet insertion in children. Methods This study was systematic review and Meta-Analysis and was conducted in Otorhinolaryngology, faculty of medicine, Ain Shams University. Results We found 17 eligible RCT(3002) children, aged from 3 years to 17 years).the included studies were graded at low risk of bias over all. The meta-analysis for postoperative otorrhoea recurrence post grommet insertion in children revealed a risk [M-H RR = 0.499 (95% CI: 0.337 – 0.737), p < 0.01], indicating a significant difference with more otorrhoea recurrence risk toward control group than post- operative Antibiotics (Abs) eardrops (ED) group. The meta-analysis for tubal blockage post grommet insertion in children revealed a risk [M-H RR = 0.612 (95% CI: 0.324 – 1.154), p = 0.129], indicating a non-significant difference with more tubal blockage risk toward control group than post-operative ABs ED group. Conclusion The overall meta-analysis revealed better results and favored the post- operative Abs ED group over control group post grommet insertion in children. We concluded that antibiotic eardrops were effective in preventing postoperative otorrhoea and obstruction following grommet insertion in children. Future studies on this topic should seek to clarify whether particular subgroups of patients benefit more from prophylactic topical antibiotics and model for cost-effectiveness.