Aminoglycoside or Quinolone Ear Drops in the Postoperative Management of Tympanoplasty: What Choice Do We Have?
Ear drops are frequently prescribed in the postoperative management of tympanoplasty, especially for episodes of acute otitis externa (5). In tympanoplasty, ear surgeons use different surgical techniques and different graft materials to repair the perforated TM (6). A large number of autologous tissues, homografts, and synthetic materials were described as graft options (7). Traditionally, temporalis muscle fascia and tragus cartilage have been widely used (8). According to the recent findings regarding quinolone ear drops (1,2), they could rationally increase the risk of recurrent TM perforations after tympanoplasty, especially when collagenous tissues (i.e., fascia and cartilage) have been grafted for reparation of the TM.
Until we will not have a deeper understanding regarding the safety of quinolone topical applications on the ear, it is our opinion that, in the presence of an intact repair TM after tympanoplasty, ear surgeons should consider to prescribe aminoglycoside over quinolone ear drops to reduce the risk of a recurrent TM perforation.