“The literature surveyed supports the administration of dexamethasone as a very effective agent for prevention of postoperative nausea and vomiting in these frequently performed procedures,” she said. An area for future research involves patients who go on to suffer nausea and vomiting in the first one to three days, even after discharge.
Explore This IssueMay 2018
“An important question is, what is the incidence of such post-discharge nausea and vomiting, and which longer-acting additional medications might be most optimal to prevent this complication?” she said.
Are Water Precautions Necessary After Tympanoplasty Tube Placement?
After the commonly performed tympanostomy tube insertion, the traditional recommendation is that children avoid water exposure to reduce the risk of postoperative otorrhea, said Richard Goode, MD, professor of otolaryngology, emeritus, at Stanford University in Palo Alto, Calif.
But is this precaution really necessary? Not really, Dr. Goode said. He pointed to studies such as a meta-analysis that included five controlled studies with a pooled analysis of 619 patients who had undergone tube placement. None of the studies found a statistically significant difference between children who swam without ear protection and non-swimmers (Laryngoscope. 1999;109:536-540).
In another study, researchers found no differences in the overall incidence of otorrhea between swimmers and non-swimmers. They also found that a child would have to wear ear plugs for 2.8 years to prevent one episode of otorrhea.
Dr. Goode pointed out that there is extensive literature on this question, and there is room to debate about whether he focused on the right studies. But he said he has changed his mind after thinking for years that “of course” ear plugs should be worn after the procedure. “Water precautions should not be routinely advised after tube placement,” Dr. Goode said.
Thomas Collins is a freelance medical writer based in Florida.