Phenylephrine and the Prevention of Postoperative Tympanostomy Tube Obstruction

Objective To determine the efficacy of phenylephrine hydrochloride, a topical vasoconstrictor, in preventing tympanostomy tube obstruction. Design Prospective, randomized, double-blind, controlled trial of patients undergoing myringotomy with tympanostomy tube insertion. Setting Academic, tertiary referral medical center. Patients Two hundred eight patients were enrolled in the study; 157 patients (310 ears) returned for postoperative evaluation. Interventions Myringotomy with tympanostomy tube insertion was performed in all ears: 139 control ears received ototopical antibiotics and 171 treatment ears received ototopical antibiotics plus topical phenylephrine. Main Outcome Measure Postoperative tympanostomy tube obstruction. Results The overall incidence of tympanostomy tube obstruction was 5.2%: 8.6% in the control group and 2.3% in the treatment group. The treatment group demonstrated an odds ratio of 0.25 (95% confidence interval, 0.08-0.78; P =.02). Conclusion The use of phenylephrine following tympanostomy tube insertion greatly reduces the incidence of tube obstruction.