Ototoxicity of ototopical drops--an update.

Various topical preparations are widely used for treating external otitis, acute otitis media with perforation, post-tympanostomy tube otorrhea, and chronic suppurative otitis media. Solutions and suspensions that enter the middle ear through a perforated tympanic membrane can reach the inner ear by crossing through the round window membrane. The safety of various components of otic solutions used in this way, particularly aminoglycosides, corticosteroids, solvents, and preservatives, has been questioned in light of their ototoxic potential.

Guidelines for the treatment of tympanostomy tube otorrhea.

Treatment of tympanostomy tube otorrhea has evolved with numerous studies demonstrating the superiority of topical therapy in the form of eardrops over systemic antibiotic therapy. Many physicians have been concerned about ototoxicity with antibiotic eardrops because several ototopical agents have a risk of vestibular and cochlear damage, which may be permanent. An expert round table of pediatric and general otolaryngologists, pediatricians, and family physicians met in Quebec City in May 2004 to develop practical Canadian guidelines for the safe treatment of tympanostomy tube otorrhea.

Image-guided sinus surgery.

Image-guided sinus surgery is a relatively new technology used to track the position of endoscopic instruments placed within the nose or sinus cavities. The different types of image-guided technologies are reviewed. A review of our experience with 55 patients in whom this technology was used over a 10-month period is presented.

Control of bleeding in endoscopic sinus surgery: use of a novel gelatin-based hemostatic agent.

Objective: To determine whether FloSeal Matrix Hemostatic Sealant is a safe and effective means of controlling bleeding post-endoscopic sinus surgery (ESS) and to assess postoperative healing.

Design: Prospective clinical study.

Setting: University of Toronto.

Acute bacterial sinusitis in adults: management in the primary care setting.

Sinus disease is inherently associated with viral upper respiratory tract infections and occurs in 90% of individuals with the common cold. Acute bacterial sinusitis occurs in 0.5 to 2% of these individuals.