tetracycline 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

In chylous fistulas following radical neck dissections, we have found reexploration to be unrewarding, with infrequent identification of a specific leakage site intraoperatively and persistent fluid accumulation postoperatively. As an alternative, we injected tetracycline hydrochloride into the supraclavicular wound bed. This procedure resulted in a rapid, sustained decline in fistula output in two of three cases, avoiding surgical intervention. Tetracycline sclerotherapy has been described for treatment of intrathoracic and other intracavitary fluid collections. We believe that tetracycline sclerotherapy is an effective adjunct in the management of chylous fistulas following radical neck dissections and that this therapy should be attempted before surgical reexploration.

Topics: Adenocarcinoma; Aged; Carcinoma, Squamous Cell; Chyle; Drainage; Female; Fistula; Head and Neck Neoplasms; Humans; Male; Methods; Neck Dissection; Parotid Neoplasms; Postoperative Complications; Sclerosing Solutions; Tetracycline; Time Factors