Tobramycin-dexamethasone Ointment in the Pediatric Airway: A Novel Adjuvant Therapy

Monday, October 19, 2026

10:18 AM - 10:24 AM PT

Location: 409AB

Presenting Author(s)

Cyrus W. Abrahamson

Medical Student
Northwestern University Feinberg School of Medicine
Chicago, IL, United States

Co-Author(s)

AL

Abbey L. Landini, n/a

Medical Student
Northwestern University Feinberg School of Medicine
Chicago, IL, United States
MF

Maya Frost, n/a

Medical Student
Northwestern University Feinberg School of Medicine, United States
AT

Abhinav Talwar, MD, MBA

Resident Physician
Northwestern Medicine Department of Otolaryngology - Head & Neck Surgery, United States
Jonathan B. Ida, MD, MBA

Associate Professor of Otolaryngology-Head and Neck Surgery
Lurie Children's Hospital Division of Otorhinolaryngology - Head and Neck Surgery
Chicago, Illinois, United States
Dana M. Thompson, MD MS MBA FACS

Professor and Division Chief of Pediatric Otolaryngology
Northwestern University Feinberg School of Medicine and Lurie Children's Hospital
Chicago, IL, United States

Senior Author(s)

Taher S. Valika, MD

Associate Professor
Lurie Children's Hospital
Chicago, Illinois, United States

Disclosure(s):

Cyrus W. Abrahamson:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Dana M. Thompson, MD MS MBA FACS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Pediatric patients with tracheostomies and endotracheal tubes are at significant risk of granulation tissue formation and airway stenosis, complications associated with increased morbidity, prolonged hospitalization, and potential need for future surgical intervention. Tobramycin-dexamethasone (TD) ointment provides broad-spectrum antibiotic coverage with anti-inflammatory properties and may help to reduce local infection and inflammation while maintaining airway patency.

Methods: This was a single-institution retrospective review of pediatric patients who received more than one application of TD 0.3%-0.1% ophthalmic formulation ointment in the airway. Demographic, clinical, and operative data were extracted from the medical record. Detailed information regarding TD administration including dose, duration, frequency, recorded benefits, and adverse effects including endocrine, metabolic, inflammatory, infectious, and pulmonary complications, was collected. Adverse events were considered possibly TD-related if they occurred during or within 30 days of administration and lacked an alternative explanation.

Results: 42 patients were identified from 2017-2025. The most common indications for TD application were glottic and subglottic granulation tissue and erosion of the subglottic mucosa. Subglottic stenosis was present in 69% of patients. The mean duration of treatment was 5.9 ± 3.5 days. 90.5% had it applied daily while 9.5% had it twice daily. Decreased or absent new granulation was noted in 38.1% of patients. Among intubated patients, 55% were extubated soon after TD use, with a mean time to extubation of 1.7 ± 2.1 days. TD was well tolerated, with only two patients requiring sedation for application, and no patients experienced any adverse effects.

Conclusions: Tobramycin-dexamethasone appears safe for use in pediatric patients with glottic and subglottic granulation and was associated with improved clinical outcomes. Further studies are necessary to better delineate its benefits compared with other adjunctive therapies.