RT Journal
A1 Whitaker GT, Collins WO, Antonelli PJ
T1 FAilure of fluorescence to reveal middle ear penetration of quinolone drops
JF Archives of Otolaryngology–Head & Neck Surgery
JO Archives of Otolaryngology–Head & Neck Surgery
YR 2011
FD December 1
VO 137
IS 12
SP 1232
OP 1235
DO 10.1001/archoto.2011.205
UL http://dx.doi.org/10.1001/archoto.2011.205
AB Objective 
                  To evaluate the utility of fluorescence to assess penetration of quinolone ear drops (EDs) through tympanostomy tubes (TTs), the middle ear, eustachian tube, and into the oropharynx.Design 
                  Before-and-after trial.Setting 
                  Academic, tertiary care hospital.Patients 
                  Young children undergoing TT placement for otitis media and adolescents or adults undergoing repair of tympanic membrane (TM) perforations were included.Interventions 
                  Fluorescence of ofloxacin otic solution and serial dilutions was assessed with a Wood's lamp in vitro. Passage of ototopically administered ofloxacin into the pharynx was assessed in patients at the time of TT placement or TM repair. The oropharynx was visualized for fluorescence with a UV light for up to 2 hours after otic instillation.Main Outcome Measure 
                  Oropharyngeal fluorescence.Results 
                  Ofloxacin otic fluorescence was visible at up to a 1:4 dilution. Fluorescence was confirmed in vivo by placing 1 drop of ofloxacin into the posterior pharynx and visualizing it transorally. Fluorescence was not identified in any of 20 patients after TT placement and in any of 6 patients prior to tympanoplasty. Two patients undergoing tympanoplasty reported tasting the EDs.Conclusion 
                  Fluorescence is not a satisfactory method of assessing quinolone ED penetration through TTs and TM perforations, the middle ear, and into the nasopharynx.