Use of bacitracin for neurotologic surgery

Abstract

Wound infection, cerebrospinal fluid leak, and meningitis are serious potential complications of neurotologic procedures that transgress the posterior cranial fossa dura. A study of 236 patients was made to determine the effect of perioperative intravenous antibiotics and topical bacitracin irrigation on the incidence of these complications. Of the 236 patients, 170 (72%) underwent translabyrinthine resection of acoustic tumors, while 66 (28%) underwent retrolaby- rinthine vestibular nerve section. Patients were divided into four groups: Those who received no antibiotics, those who received perioperative intravenous antibiotics only, those who received topical bacitracin irrigation only, and those who received a combination of perioperative intravenous antibiotics and topical bacitracin irrigation. There were no untoward effects of either perioperative intravenous antibiotics or topic&l bacitracin. The results indicate that bacitracin irrigation reduced the incidence of wound infection from 9% to 2% (p<0.05); of cerebrospinal fluid leak from 12% to 5% (p<0.04); and of all targeted complications combined from 22% to 9% (p<0.006). Furthermore, the topical bacitracin irrigation only group showed a statistically significant reduction in wound infections compared to the perioperative intravenous antibiotic only group (p<0.02). The incidence of meningitis was statistically unaffected by any of our treatment protocols. © The American Laryngological, Rhinological and Otological Society, Inc.