Otitis externa treated by topical antibiotics

P 116

Otolaryngology Head and Neck Surgery August 1997

Scientific Sessions- - Tuesday

all patients undergoing endoscopic septoplasty by the senior authors between 1993 and 1996. Results: One hundred eleven consecutive cases were reviewed, with a mean follow-up time of 9.3 months. Ninetytwo percent of cases were performed in conjunction with functional endoscopic sinus surgery. Indications for septoplasty included impaired surgical access in 68% (75/ 111) and nasal obstruction in 39% (43/111). Fifteen percent of patients (17/111) had a history of previous septal surgery. Adverse sequelae were identified in 2% (2/111), consisting of one septal hematoma and one septal perforation. Six patients developed minor synechiae, and one patient required surgical revision. Conclusions: We conclude that endoscopic septoplasty is an effective and safe technique that provides significant clinical and teaching advantages over traditional approaches. Rationale for case selection and intraoperative videos of surgical technique will be presented. 11:30 AM Radiation Therapy Versus CO 2 Laser Excisional Biopsy for Early Glottic Tumors: A Comparison of Voice Results KATHELIJNE G. DELSUPEHE,MD (presenter), INGE ZINK, PhD, MARYLINE LEJAEGERE, and ROBERTW. BASTIAN, MD, Leuven, Belgium, and Maywood, IlL

Objective: For early glottic tumors, both radiation therapy and CO z laser excision are reported as successful in controlling disease to levels as high as 90%. Thus far, however, no comparison of long-term voice results has been reported. The purpose of this study was to compare voice results between groups that underwent radiation therapy and surgery preoperatively, early postoperatively, and then at 6 months and 2 years postoperatively. Materials and methods: Forty-two patients with early glottic tumors were evaluated retrospectively. Twelve had been treated with radiation therapy and 30 by CO 2 laser excision. A standardized voice sample was recorded preoperatively, early postoperatively, and 6 months and 24 months after treatment. This large set of voice samples was rated by eight judges (four trained and four untrained). All judges rated voice quality, loudness, and air wastage. The trained judges also rated fluency, effort, and fundamental frequency. Spearman's correlation coefficient and K test showed good interjudge and intrajudge variabilities. Ratings of the two most consistent judges for each test were used for statistical analysis. Results: Groups were similar with respect to tumor size and location as well as pretreatment levels of voice disturbance. A similar trend for the evolution of voice quality was observed for all parameters except for the effort criterion. In the surgical group the voices got worse early after treatment and improved to a statistically significant degree at 6 and 24 months compared with preoperative and early postoperative values. Voices improved gradually without temporary worsening in the group that underwent radiation therapy. There were no statistically significant differences between the two groups for any of the voice parameters at 6 and 24 months.

Conclusions: Both radiation therapy and laser excision give very similar long-term voice results. Temporary worsening of the voice occurs early after treatment in the surgical group. 11:38 AM Otitis Externa Treated by Topical Antibiotics TORBEN LILDHOLDT, MD, PhD (presenter), PIERREGEHANNO, MD, WOLFGANG KEHRL, MD, and ALBERTO LEIBERMAN, MD, Horsens, Denmark, Paris, France, Hamburg, Germany, and Beer Sheva, Israel

Objective: Efficacious, nonototoxic drugs for topical treatment of the external ear canal have not been previously available. The present study investigated the efficacy and safety of new otic formulations of ciprofloxacin versus today's standard of Polymyxin B-neomycin-hydrocortisone. Methods: Identical multicenter protocols were used in nine countries in Europe and Israel. Patients with clinical signs and symptoms of acute, diffuse external otitis were randomized to one of three treatment modalities for 7 days; test drugs were ciprofloxacin, 0.2% solution, or ciprofloxacin, 0.2% - hydrocortisone 1% otic suspension administered as three drops twice daily. The control drug was a suspension of Polymyxin B-neomycin sulphate 3.5 mg/ml-hydrocortisone 1% administered as four drops three times daily. Results: A total of 838 patients entered the study. The data analysis in general showed equal efficacy and safety of the three treatment groups. The clinical evaluation at end of treatment showed resolution or improvement in about 95% of patients, and this was maintained at follow-up about 3 weeks later. The median time to end of ear pain was 4.8 days with no statistically significant differences between groups. Ear cultures showed Ps. aeruginosa before treatment in 323 of 503 ears (64%) showing bacteria. After treatment this bacteria persisted in 9 of 103 ears (8.7%) and 11 of 117 ears (9.4%) in the test groups, respectively, and in 22 of 103 ears (21.4%) ears in the control group (Fischer's exact test: p < 0.03). Conclusions: Ciprofloxacin ear drops is a new therapeutic alternative in otitis externa characterized by absence of ototoxicity and high efficacy against Ps. aeruginosa. 11:46 AM

Laser-assisted Uvulopalatoplasty for Treatment of Obstructive Sleep Apnea: Results in Patients with Mild, Moderate, and Severe Apnea REGINA P. WALKER, MD (presenter), THOMAS GARRITY, MD, MADELEINE M. GR{GG-DAMBERGER, MD, and CHELLAM GOPALSAMI, PhD, Maywood, III.

Objective: Laser-assisted uvulopalatoplasty (LAUP) has been used to treat patients who snore and patients with mild cases of obstructive sleep apnea (OSA). The purpose of this study was to prospectively evaluate the efficacy and safety of LAUP in patients with mild, moderate, and severe OSA. Methods: Thirty-eight patients underwent LAUP for the treatment of OSA. Fifteen had mild apnea, 12 had moderate