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

Abstract

Clinicians often prescribe otic drops anecdotally to try and clear grommets blocked with blood. We carried out an in vitro double-blind randomized controlled study comparing the efficacy of sodium bicarbonate, Locorten Vioform and olive oil drops in clearing Shah grommets placed in 'artificial ears' and blocked with blood in a standardized fashion. There were 33 grommets in each group, and drops were inserted three times a day for 7 days. Olive oil drops cleared 17 of 33 (51.51%), Locorten Vioform cleared one of 33 (3%) and sodium bicarbonate cleared zero of 33 (0%) blocked grommets. Statistical comparison between pairs indicates that olive oil was significantly better than both Locorten Vioform (P < 0.001) and sodium bicarbonate drops (P < 0.001) at clearing grommets blocked with blood.

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

“…TT blockage has been reported as low as 7% and as high as 25% [4,5]. A study in 1991 reported that approximately 50% of blocked tubes were a result of blood clot from the time of surgery [6]. We have observed postoperative TT blockage secondary to a blood clot to be associated with more bleeding at the time of TT insertion.…”

“…Many reasons exist for TTs to become blocked after insertion, and frequent bleeding is a reason for this blockage. This can be attributed to many factors, including inflammation of the middle ear or tympanic membrane, patient coagulation profile, and also surgeon skill and experience [6]. Intraoperative blood clots can lead to significant problems with postoperative TT blockage, and thus may necessitate further treatments and in some instances, a second surgical intervention to replace the TTs.…”

“…Although vinegar has been used in the ear without reported ototoxicity, there is no data on the use of hyaluronidase in the ear, and it has not been FDA approved for this use [4]. A study in 2004 compared dissolution rates of blood clot in in vitro TT models using sodium bicarbonate, steroid-antibiotic drops (clioquinolflumethasone), and olive oil for comparison [6]. Only grommets TTs were used, solutions were instilled in the ear models 3 times daily for 7 days.…”

“…Only grommets TTs were used, solutions were instilled in the ear models 3 times daily for 7 days. Olive oil cleared blood clots significantly better than bicarbonate and steroid-antibiotic drops (p < 0.001) [6].…”

A comparison of different treatment modalities used as otorrhea prophylaxis following ventilation tube placement

“…Various factors have been thought to be responsible in the etiology such as tube diameter, the shedding of epithelial cells, poor surgical technique, and insufficient hemostasis. [20] Although the high viscosity of ear drops containing steroids has been considered to be a cause, there are extremely limited data related to the incidence of tube obstruction associated with ear drops. [13] Samarei [8] compared topical ofloxacin ear drops and ciprofloxacin/ dexamethasone combination and reported the tube obstruction rate to be 5.2% in the ofloxacin group and 6% in the ciprofloxacin/ dexamethasone combination.…”