povidone-iodine and Parotid-Neoplasms

The treatment of MRSA (methocillin resistant staphylococcus aureus) colonized middle ear is difficult. According to the guidelines, a MRSA colonized Patient is not to be treated with systemic antibiotics. The topical treatment shows the problem of the ototoxicity of most of the used antiseptic as well as antibiotic substances.. Selective literature review and consideration of the author's own clinical experience.. Antibiotic treatment options include aequeous Tetracyclin drops, aequeous chloramphenicol drops and quinolon ear drops (unfortunately the MRSA is resistent mostly). Antiseptics without ototoxic effects are the Burow's solution, Povidone-iode, acetic acid solutions and aequeous dequalinium solutions.

Topics: Acetates; Acetic Acid; Administration, Topical; Aged; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chloramphenicol; Dequalinium; Guideline Adherence; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Middle Ear Ventilation; Otitis Media with Effusion; Parotid Neoplasms; Pharmaceutical Solutions; Postoperative Complications; Povidone-Iodine; Quinolones; Staphylococcal Infections; Tetracycline

Frey's syndrome after parotidectomy has an incidence generally reported to be 50% to 60% and is thought to be due to aberrant reinnervation of sweat glands by postganglionic parasympathetic fibers normally supplying the parotid gland. One hundred twelve patients had interposition of a flap of the superficial musculoaponeurotic system between the parotid bed and the overlying skin. Only one patient developed symptomatic Frey's syndrome, and one other patient had positive results on starch iodine testing. In patients not having the interposition, the incidence of symptomatic Frey's syndrome and positive starch iodine testing was 83% and 87%, respectively.

Topics: Humans; Methods; Muscles; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Povidone-Iodine; Reoperation; Starch; Surgical Flaps; Sweat Glands; Sweating, Gustatory

Twenty-one patients were followed up with a home visit after having parotid surgery at the Westmead Centre between January 1988 and October 1989. Nine of these patients (42.8%) had objective gustatory sweating as proven by Minor's Starch Iodine Test, with three of these (14.3%) having symptoms of Frey's syndrome. Symptoms started an average of 4.3 months after surgery. None of the three were anxious enough about their symptoms to seek medical treatment. Those patients with objective gustatory sweating were more likely to be women. No statistical significance was found in regard to the presence or absence of greater auricular nerve section, facial nerve paresis, age or type of operation (superficial parotidectomy or otherwise). Frey's syndrome is a benign condition and explanation and reassurance are usually adequate therapy.

Topics: Adult; Aged; Aged, 80 and over; Ear, External; Facial Paralysis; Female; Humans; Intraoperative Complications; Male; Middle Aged; Parotid Gland; Parotid Neoplasms; Postoperative Complications; Povidone-Iodine; Retrospective Studies; Sex Factors; Starch; Sweating, Gustatory