Prednisolone Sodium Phosphate/Sulfacetamide Sodium

Some widely used ototopical preparations are potentially toxic to the middle and inner ear. Vasocidin Ophthalmic Solution (sulfacetamide sodium and prednisolone sodium phosphate) has been advocated as an alternative agent that may have fewer toxic side effects in the treatment of otorrhea. Vasocidin was introduced into the bullae of nine chinchillas to investigate the effects on the middle and inner ear. The organ of Corti and stria vascularis were found to be entirely normal in 17 of the 18 temporal bones studied. Changes observed in the middle ears at one week included inflammation, hemorrhage, and effusion. Examination of specimens at four weeks revealed resolution of most of the inflammatory changes. The results of this experimental study indicate that Vasocidin causes reversible middle ear inflammation with little or no toxic effect on inner ear structures.

To the Editor. —Causes of abduction deficits include various congenital and acquired syndromes of the extraocular muscles and the sixth cranial nerve. We describe a patient with an abduction deficit secondary to a presumed, spontaneous bacterial dacryoadenitis that responded promptly to appropriate intravenous antibiotics. Report of a Case. —A 20-year-old woman developed discomfort on right gaze, and mild right upper eyelid swelling, which was initially treated with topical vasocidin. During the next two days as the pain increased and a mucopurulent discharge developed, she experienced horizontal binocular diplopia worse on right gaze. Naphazoline hydrochloride (Naphcon-A) and erythromycin (Ilotycin) therapy was started and the patient was referred to our unit. Uncorrected visual acuity was 20/30 bilaterally. Right upper eyelid edema, erythema, ptosis, and a mucopurulent discharge were present in association with an abduction deficit of the right eye (Fig 1). No predisposing skin lesions or signs of local trauma were found.