Does topical N-acetylcysteine application after myringotomy cause severe otorrhea?

Objectives: The effect of topical N-acetylcysteine (NAC) application was investigated on the healing of acute experimental tympanic membrane perforations.

Materials And Methods: Twenty guinea pigs were used in this study. Under intraperitoneal ketamine anesthesia, incisional myringotomies were performed in the posterosuperior quadrant of the tympanic membranes with a straight otologic hook. The diameter of the perforations was approximately 2 mm. Perforations in both ears were treated with freshly prepared sponges soaked in either 0.1 ml 0.9% NaCl solution (10 control animals) or 0.6 mg/0.1 ml NAC (10 animals) for three consecutive days. All the tympanic membranes were examined by otomicroscopy on the third, fifth, seventh, and ninth days.

Results: In the control group, all the perforations were completely closed at the end of nine days. During the same period, only 40% of the perforations were completely closed in the NAC group. The remaining ears exhibited otorrhea by the third day.

Conclusion: N-acetylcysteine may cause severe otorrhea in the healing process of tympanic membrane perforations. Further studies including histopathological examinations are required to elucidate this condition.