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Systematic review of ototoxic pre-surgical antiseptic preparations – what is the evidence?

Overview of attention for article published in Journal of Otolaryngology - Head & Neck Surgery, March 2018
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Title
Systematic review of ototoxic pre-surgical antiseptic preparations – what is the evidence?
Published in
Journal of Otolaryngology - Head & Neck Surgery, March 2018
DOI 10.1186/s40463-018-0265-z
Pubmed ID
Authors

Shubhi Singh, Brian Blakley

Abstract

There is uncertainty regarding the safety of surgical antiseptic preparations in the ear. A systematic review of the literature was conducted to assess the evidence regarding ototoxicity of surgical antiseptic preparations. A literature search was conducted using the PRISMA methods. Key words included "ototoxicity" "hearing loss", "antiseptic", "surgical preparation", "tympanoplasty", "vestibular dysfunction", "chlorhexidine", "iodine", "povidone", "ethanol", and "hydrogen peroxide" using Medline, Embase, Cochrane Library, Scopus and Web of Science. We included peer-reviewed papers that 1) objectively measured ototoxicity in humans or animals through hearing, vestibular function or histologic examination, 2) studied topically applied surgical antiseptic preparations, 3) were either in English or had an English abstract. We excluded papers that were 1) in vitro studies, 2) ear trauma studies, 3) studies of ototoxic ear drops intended for therapy, or 4) case reports. Studies included in the final review were screened using the PRISMA method. Current systematic review registration number pending: 83,675. Fifty-six papers were identified as using PRISMA criteria. After applying our exclusion criteria, 13 papers met overall study criteria. Of these, six papers reported ototoxicity of iodine based solutions, five papers reported ototoxicity of chlorhexidine and ethanol and two papers assessed hydrogen peroxide. All papers reviewed were animal studies. Iodine based solutions show least harm overall, while chlorhexidine and high concentrations of alcohol based solutions showed most harm. The evidence on hydrogen based solutions was inconclusive. The overall evidence for anyone antiseptic solution is weak. There is some evidence that iodine, chlorhexidine, hydrogen peroxide and alcohol based antiseptics have ototoxicity. Conclusive evidence for human ototoxicity from any solution is not strong.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 54 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 13%
Student > Bachelor 7 13%
Other 6 11%
Researcher 4 7%
Student > Postgraduate 4 7%
Other 9 17%
Unknown 17 31%
Readers by discipline Count As %
Medicine and Dentistry 25 46%
Veterinary Science and Veterinary Medicine 3 6%
Nursing and Health Professions 3 6%
Immunology and Microbiology 2 4%
Sports and Recreations 1 2%
Other 1 2%
Unknown 19 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 June 2019.
All research outputs
#15,229,642
of 25,461,852 outputs
Outputs from Journal of Otolaryngology - Head & Neck Surgery
#236
of 629 outputs
Outputs of similar age
#183,750
of 345,064 outputs
Outputs of similar age from Journal of Otolaryngology - Head & Neck Surgery
#5
of 12 outputs
Altmetric has tracked 25,461,852 research outputs across all sources so far. This one is in the 38th percentile – i.e., 38% of other outputs scored the same or lower than it.
So far Altmetric has tracked 629 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.1. This one has gotten more attention than average, scoring higher than 60% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 345,064 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 12 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 58% of its contemporaries.