I have some concerns regarding the article "Phenylephrine and the Prevention of Postoperative Tympanostomy Tube Obstruction"1 in last November's issue of the ARCHIVES. The authors recommend the ototopical administration of 4 drops of 0.025% phenylephrine hydrochloride to reduce the incidence of tympanostomy tube obstruction secondary to blood and/or secretions encountered at the time of myringotomy and tube placement. To my knowledge, the most dilute solution of phenylephrine hydrochloride commercially available is a 0.125% drop formulation. The authors make no specific mention of diluting either this or the 0.25%, 0.5%, or 1.0% solutions commercially available in drops and sprays.
Cunningham MJ. Caution Advised When Using Diluted Phenylephrine Hydrochloride. Arch Otolaryngol Head Neck Surg. 1999;125(10):1170. doi: