Improving the penetration of ototopicals through tympanostomy tubes: Role of surfactants

Samuel A. Reyes, Lee P. Smith, Ramzi T. Younis

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: To evaluate the ability of surfactants to increase the penetration of ototopicals through tympanostomy tubes (TT). Methods: An in vitro model was used to test the penetration of ototopicals with and without two surfactants (docusate sodium and beractant) through fluoroplastic and titanium TTs. The model was created by placing a TT through a perforation (myringotomy) in a model of the tympanic membrane (silastic sheet) fixed between the ends of two 1 mL syringes. Measurements were recorded of the maximum height various solutions (distilled water, soapy water, ofloxacin otic, ciprofloxacin/dexamethasone otic) achieved before penetrating the TTs (1.27 mm Reuter Bobbin titanium, 1.27 mm fluoroplastic). These same measurements were then performed with the addition of docusate sodium or beractant to the distilled water and each of the ototopical solutions. Results: The addition of docusate sodium significantly increased the penetration of water and ofloxacin otic through both types of TTs. It significantly increased penetration of ciprofloxacin/dexamethasone otic through fluoroplastic tubes with a trend towards increased penetration through titanium tubes. Adding beractant showed a modest trend toward increasing the penetration of both ototopicals in fluoroplastic tubes which did not reach statistical significance. Conclusions: These results demonstrate that the penetration of ototopicals through TTs can be improved by the addition of surfactants. Increasing the penetration of ototopicals may make them more effective in treating TT otorrhea. However, we strongly discourage clinicians from using these compounds clinically until their safety has been established.

Original languageEnglish (US)
Pages (from-to)69-72
Number of pages4
JournalInternational Journal of Pediatric Otorhinolaryngology
Issue number1
StatePublished - Jan 2008


  • Otitis media
  • Otorrhea
  • Ototopicals
  • Surfactant
  • Tympanostomy tube

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine
  • Surgery


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