Skip to main content
AAO-HNSF 2023 Annual Meeting & OTO Experience Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Otology/Neurotology

Tympanoplasty Microbiome and Otic Quinolone Exposure Assessed From Gelatin Sponge

Monday, October 2, 2023
9:15 AM - 9:21 AM East Coast USA Time
Location: 104BC

    Presenting Author(s)

  • Arunima Vijay, BA

    Medical Student
    University of Florida
    Odessa, Florida, United States

    • Co-Author(s)

  • CD

    Carolyn O. Dirain, PhD

    Associate Scientist
    University of Florida
    Gainesville, FL, United States

  • SC

    Si Chen, MD

    Resident
    University of Miami Miller School of Medicine
    Miami, Florida, United States

  • Rex S. Haberman, II, MD

    Associate Professor
    University of Florida
    Gainesville, FL, United States

    • Senior Author(s)

  • Patrick J. Antonelli, MD, MS

    Professor of Otolaryngology, Neuroscience, and Speech, Language, and Hearing Sciences
    University of Florida
    Gainesville, FL, United States

Disclosure(s):
Arunima Vijay, BA: No relevant relationships to disclose.
Rex S. Haberman, MD, II: No relevant relationships to disclose.
Introduction: Healing following tympanoplasty may be influenced by numerous factors, including the microbiome and exposure to otic antibiotics. Study of post-tympanoplasty wound healing is limited by the ear’s small size, high sensitivity, and relative inaccessibility. We aimed to determine if absorbable gelatin sponge (AGS) can be used to assess the post-tympanoplasty microbiome and otic antibiotic exposure.

Methods: Patients undergoing tympanoplasty and receiving ofloxacin otic (3,000 μg/mL) postoperatively were prospectively enrolled. Intraoperatively, epinephrine-soaked AGS was applied to the medial ear canal/tympanic membrane (TM) for 1 minute after incision, then removed and saved for analysis. Ear canals were packed with saline-soaked AGS at the end of surgery. At the first post-operative visit, AGS was collected from the meatus and TM separately. Samples were analyzed by microbial culture and mass- spectrometry for quinolone levels.

Results: Forty-two patients were enrolled. Microbes were commonly recovered. At surgery, 79 and 9.5% of AGS cultured on general purpose media, blood or chocolate agar, yielded bacteria and fungi, respectively. Culture on selective media showed 69% had Staphylococcus species and 12% had Pseudomonas species. Postoperatively, 67% of meatus AGS had bacteria, 21% had fungi, 50% had Staphylococcus and 29% had Pseudomonas. TM samples yielded bacteria in 65%, fungi in 4%, Staphylococcus in 54%, and Pseudomonas in 21%. S. epidermidis was most common species, followed by S. aureus and P. aeruginosa. Ofloxacin concentration at the meatus was 248 μg/mL (95% CI: 119-377), and at the TM was 126 μg/mL (95% CI:58-194).

Conclusions: The post-tympanoplasty wound microbiome and exposure to otic antibiotics may be assessed non- invasively through AGS analysis. Despite exposure to a high concentration of quinolones, the tympanoplasty wound is far from sterile. Otic antibiotic administration may result in fungal overgrowth, which could impact healing outcomes.