A New Trend in the Management of Pediatric Deep Neck Abscess: Achievement of the Medical Treatment Alone

Abstract

Objective: We aimed to examine the effect of topical dexamethasone by otomicroscopic and histologic examinations for preventing myringosclerosis induced by myringotomy in rat tympanic membranes.Methods: Twenty-one Sprague Dawley rats (42 ears) were randomly divided into the following three groups after otomicroscopic examinations: experimental surgical group (5 rats), control group (8 rats), and study group (8 rats). The rats of all the groups underwent myringotomy in both tympanic membranes. Other than myringotomy, no additional procedure was performed for the rats in the experimental surgical group. In the control group, 0.9% NaCl was applied to the ears, whereas in the study groups, topical dexamethasone was applied to the ears. These applications in the control and study groups were repeated for nine days. On the 10th day of the study, the rat ears of all groups underwent otomicroscopic and histologic examinations. The prevalence and process of myringosclerosis were evaluated by otomicroscopic examination, whereas inflammation, membrane thickness, and myringosclerosis intensity were evaluated by histologic examination. Results:The growth of myringosclerosis with otomicroscopic examination was lesser in the study group in which topical dexamethasone was applied than the control and the experimental surgical groups. Moreover, it was observed that myringosclerosis effected fewer quadrants in the study group.Histologic examinations revealed that inflammation was significantly lesser in the study group than in the experimental surgical and control groups. The average membrane thickness values were significantly lesser in the study group than in the experimental surgical group. With respect to myringosclerosis growth, no statistically significant difference was observed among all groups, whereas with respect to myringosclerosis intensity, the rat ears in the study group were less severely affected.Conclusion: Thus, our study results suggest that applying topical dexamethasone after myringotomy has positive effects on limiting the intensity and prevalence of myringosclerosis.

The Effect of Curcumin on the Prevention of Myringosclerosis in Rats

“…ROS can be neutralized by substances with antioxidant properties. There are many studies which show that MS formation can be prevented by applying antioxidant, anti-inflammatory, and ROS scavenging agents ( 1 , 2 , 3 , 4 , 16 , 20 , 21 , 22 ).…”

“…Dündar et al ( 2 ) demonstrated that ascorbic acid and/or N-acetylcysteine treatments reduced the development of MS by reducing inflammation scores and cellular infiltration. Üstündağ et al ( 3 ) found that topical application of dexamethasone in rats after myringotomy has positive effects in reducing both the severity and prevalence of MS. Kargin Kaytez et al ( 4 ) used montelukast orally and topically in rats after myringotomy and reported that it reduced FP and TM thickness. Kazikdas et al ( 20 ) suggested that the prevalence of myringosclerotic plaques was less in rats receiving alpha-tocopherol intramuscularly.…”

“…It is caused by middle ear infections or surgical intervention to the TM ( 2 ). Especially in the treatment of otitis media with effusion in children, the incidence of MS has been reported as 28%-61% depending on the frequency of ventilation tube application ( 3 , 4 ). Recent studies have shown that hyperoxidative damage and free oxygen radicals may be the main cause of MS formation ( 1 , 5 ).…”

The Short-Term Effect of Eugenol on the Prevention of Experimentally Induced Myringosclerosis in a Rat Model

“…Whereas MS is identified histologically in 80% of cases after myringotomy it can be identified under otomicroscopy in only 40% of the cases. This suggests that the actual number of tympanosclerosis cases detected with otomicroscopy could be two-fold ( 6 ). To support this, in a study by Santos et al ( 17 ), the sensitivity and specificity of otomicroscopy was found 80% and 75%, respectively.…”

“…Several studies reported that the incidence of MS was much higher in cases with a history of ventilation tube placement compared to without. These studies also reported the incidence in pediatric patients to range between 28 and 61% ( 5 , 6 ).…”