Cholesteatoma surgery is considered as a dirty one and consequently tributary of preoperative and postoperative
antibiotic treatment. Thirty-seven patients diagnosed of
cholesteatoma and surgically treated in 1994 are retrospectively analyzed in this article. All of them, whether or not presented with active preoperative otorrhea, received a protocolized
antibiotic treatment with topical
gentamicin and
dexamethasone and oral
clindamycin during seven postoperative days. The presence or absence of preoperative or postoperative
infection, usually as
suppuration is analyzed. Otopyorrhea occurred in 22 patients (62%) before surgery and only in 9 cases (25%) after surgery. Preoperative discharging ears showed greater disposition to continuing the
suppuration. The surgical technique followed and the reconstructive middle ear procedure--with autologous bone or other synthetic materials (
PORP,
TORP)--have not proved, statistically, any predictably value regarding the appearance of any active postoperative
infection. As a result of the study done, oral
ciprofloxacin has been protocolized only in those adults showing a refractory
suppuration to the
antibiotic treatment employed. In patients with preoperative otorrhea, topical
ciprofloxacin has been protocolized before surgery with the main aim to decrease the postoperative
infections incidence of these cases.