Otic drops used to clear a blocked grommet: an in vitro prospective randomized controlled study with blinded assessment

Common agents used to unblock blood clots within tympanostomy tubes: an ex vivo study and review of literature

OBJECTIVES

To determine the efficacy of common solutions used to dissolve blood clots blocking tympanostomy tubes (TTs) of differing lengths and diameters.

STUDY DESIGN

An ex vivo experimental study.

METHODS

Ear models were built by the study investigator. Tympanostomy tubes were inserted into the models and blocked with blood clots. Test solutions were applied to the blood clots, and time for clearance was recorded via microscopic visual confirmation.

RESULTS

Richards T-tube had higher odds of unclogging than collar button tubes (odds ratio: 2.37, 95% confidence intervals 1.02-5.54, p=0.042). Vinegar and 3% hydrogen peroxide were most effective for Richards T-tubes and collar button tubes, respectively.

CONCLUSION

Common solutions (vinegar and hydrogen peroxide) were more effective than antibiotic drops in clearing blood clot blocking TTs.

Tympanostomy Tube Obstruction Related to Ototopical Drug Therapy

Obstruction of tympanostomy tubes is a potentially significant complication, sometimes requiring replacement of the nonfunctioning tube. Early blockage can occur secondary to bleeding during the tube placement procedure. Delayed obstruction is usually caused by inspissated secretions or epithelial casts. We briefly report our treatment of 9 cases of delayed ventilation tube obstruction that were associated with the use of an ototopical antibiotic/steroid suspension.