Abstract
To compare the efficacy of treatment between steroid–antibiotic and 10% Ichthammol glycerine packs (IG packs) in acute otitis externa. A prospective, randomized clinical trial between steroid–antibiotic and 10% IG pack which was performed in department of ENT-HNS, Kathmandu University Hospital, Dhulikhel from July 2009 to December 2009 on 82 patients. Pain was assessed by Numerical Rating Scale (NRS) and edema was assessed by dividing the external auditory canal in four quadrant giving score of 25% for each on the day of presentation and subsequent visits till tragal tenderness and edema subsided. Age group among studied patients ranged from 10 to 60 years, with mean of 23.5 years. Out of which 42 (51.2%) were females and 40 (48.8%) were males. Average number of visits in 10% IG pack group (n = 41) was 5.4 days (2–5 visits) while in steroid–antibiotic group (n = 41) it was 3.5 days (2–5 visits). There was statistically significant decrease in the number of visits in steroid group (P < 0.05). Similarly, decrease in pain score in second visit was statistically significant (P = 0.02) in steroid–antibiotic group as compared to 10% IG pack, while the edema score in second visit while comparing steroid–antibiotic group with 10% IG pack was statistically not significant (P = 0.07), whereas it was statistically highly significant on fourth visit (P = 0.001). Since the control of pain and edema is more and hence the number of visits is significantly less in steroid–antibiotic packing group, so it is worthwhile to use steroid–antibiotic pack for effective treatment of acute otitis externa.
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References
Sundstrom J, Jacobson K, Munck-Wikland E, Ringertz S (1996) Pseudomonas aeruginosa in otitis externa. A particular variety of the bacteria? Arch Otolaryngol Head Neck Surg 122:833–836
Linstrom JC, Lucento EF (2006) Infections of the external ear. Byron J. Bailey and Jonas T Johnson’s Head and Neck Surgery—Otolaryngology. 4th edn. vol 1. Lippincott Williams and Wilkins, Philadelphia, pp 1989–1990
Ahmed K, Roberts ML, Mannion PT (1995) Antimicrobial activity of glycerine–ichthammol in otitis externa. Clin otolaryngol Allied Sci 20:201–203
Nilssen E, Wormald PJ, Oliver S (1996) Glycerol and ichthammol:medicinal solution or mythical potion? J Laryngol and Otol 110:319–321
Roland PS, Younis R, Wall GM (2007) A comparison of ciprofloxacin/dexamethasone with neomycin/polymyxin/hydrocortisone for otitis externa pain. Adv Ther 24(3):671–675
van Balen FA, Smit WM, Zuithoff NP, Verheij TJ (2003) Clinical efficacy of three common treatments in acute otitis externa in primary care: randomised controlled trial. BMJ 327(7425):1201–1205
Davies S, de Guzman A (2004) Ear drops containing steroids were better than acetic acid for otitis externa. Evid Based Nurs 7(2):43
Rusenfeld RM, Singer M, Wasserman JM, Stinnett SS (2006) Systematic review of topical antimicrobial therapy for acute otitis externa. Otolaryngol Head Neck Surg 134(4 Suppl):S24–S48
Pond F, McCarty D, O’Leary S (2002) Randomized trial on the treatment of oedematous acute otitis externa using ear wicks or ribbon gauze: clinical outcome and cost. J Laryngol Otol 116(6):415–419
Drehobl M, Guerrero JL, Lacarte PR, Goldstein G, Mata FS, Luber S (2008) Comparison of efficacy and safety of ciprofloxacin otic solution 0.2% versus polymyxin B-neomycin-hydrocortisone in the treatment of acute diffuse otitis externa. Curr Med Res Opin 24(12):3531–3542
Abelardo E, Pope L, Rajkumar K, Greenwood R, Nunez DA (2009) A double-blind randomised clinical trial of the treatment of otitis externa using topical steroid alone versus topical steroid–antibiotic therapy. Eur Arch Otorhinolaryngol 266(1):41–45
Mösges R, Domröse CM, Löffler J (2007) Topical treatment of acute otitis externa: clinical comparison of an antibiotics ointment alone or in combination with hydrocortisone acetate. Eur Arch Otorhinolaryngol 264(9):1087–1094
Sander R (2001) Otitis externa: a practical guide to treatment and prevention. Am Fam Physician 63:927–932
Bojrab DI, Bruderly T, Abdulrazzak Y (1996) Otitis externa. Otolaryngol Clin North Am 29:761–782
Gray RF, Sharma A, Vowler SL (2005) Relative humidity of the external auditory canal in normal and abnormal ears, and its pathogenic effect. Clin Otolaryngol 30:105–111
Ruckenstein MJ (2005) Infections of the external ear. In: Cummings CW et al (eds) Otolaryngology head and neck surgery, 4th edn, vol 3. Elsevier Mosby, Philadelphia, pp 2979–2987
Malcolm P Hilton (2008) Furunculosis In: Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery 7th edn. vol 3. Edward Arnold Publication, Great Britain, pp 3323–3325
Masood A, Moumoulidis I, Ray S, Chawla O, Panesar J (2008) A randomised controlled trial comparing Triadcortyl with 10% glycerine-ichthammol in the initial treatment of severe acute otitis externa. Eur Arch Otorhinolaryngol 265(8):881–885
Hornigold R, Gillett D, Kiverniti E, Harries M (2008) The management of otitis externa: a randomised controlled trial of a glycerol and ichthammol ribbon gauze versus topical antibiotic and steroid drops. Eur Arch Otorhinolaryngol 265(10):1199–1203
Bhatt R, Pokhrel R, Adhikari P, Neupane Y (2009) A comparison of 10% ichthammol glycerine pack with steroid–antibiotic pack for relieving pain in cases of acute otitis externa. J Inst Med 31(1):7–10
Neher A, Nagl M, Scholtz AW (2008) Otitis externa: etiology diagnostic and therapy. HNO 56(10):1067–1079
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Shrestha, B.L., Shrestha, I., Amatya, R.C.M. et al. Effective Treatment of Acute Otitis Externa: a Comparison of Steroid Antibiotic Versus 10% Ichthammol Glycerine Pack. Indian J Otolaryngol Head Neck Surg 62, 350–353 (2010). https://doi.org/10.1007/s12070-010-0055-z
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DOI: https://doi.org/10.1007/s12070-010-0055-z