INTRODUCTION.

Three diverse topics in otology have been selected for this "Treatment strategies in chronic ear disease" supplement to EAR, NOSE, AND THROAT JOURNAL. They have been selected for different reasons.

Post-tympanostomy tube otorrhea. I selected the article on post tympanostomy tube otorrhea because the introduction of fluoroquinolone otic drops has created controversy in this area.

Opinions vary on the exact role these potent new preparations have in the management of the draining tympanostomy tube. Do they merely supplement systemic agents? Or do they replace them entirely? Should the use of the older ototoxic  preparations be completely discontinued? Or are the new medications so much more expensive that their use should be reserved for selected cases? And what is the role of steroids?

Dr. Charles M. Myer, III, has wide experience in this area, and he addresses many of these issues in his article.

Surgery for chronic ear disease. I chose the article on surgical treatment of the draining ear because this is a rapidly changing field, especially with respect to prostheses. Dr. David S. Haynes shares the fruits of his wide experience, and he has distilled a great deal of complex and rapidly changing information into clinical pearls that we can all put to immediate use.

Chronic external otitis. I included my own article on chronic external otitis because this is such a frustrating and recalcitrant pathologic process. It is not frequently addressed in the literature, and I thought that it would be worthwhile to assemble and condense what we apparently know about this condition into a brief state-of-the-art review.

I hope there is something useful in this supplement for every practicing otolaryngologist. To provide useful information has been our goal.

Peter S. Roland, MD

Supplement Editor