An alternative to regular dressings for otitis externa and chronic supperative otitis media?

Wilde, A. D.; England, James T.; Jones, A. S.

doi:10.1017/s0022215100129391

Cited by 17 publications

(4 citation statements)

References 4 publications

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“…Also, Picozzi et al [20] reported that 64.7% of ears treated with topical gentamycin-hydrocortisone and self-mopping versus 21.4% of ears treated with topical placebo and self-mopping became dry. Wilde et al [21] observed good resolution rates in both groups of a clinical trial that compared packing the ear with wicks impregnated with tetracycline-colistin versus filling the ear with ointment without wicks.…”

Section: Discussionmentioning

confidence: 99%

Aural Toileting and Dressing—Important Intervention Measures in the Management of Acute Suppurative Otitis Media

Iseh¹,

Amutta²,

Abdullahi³

et al. 2014

IJOHNS

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Background: Otitis media is one of the most common childhood infections, the leading cause of doctor's visit by children in ENT clinic. The acute form if not recognized early is commonly characterized by suppuration from the middle ear following perforation of the tympanic membrane otherwise referred to as acute suppurative otitis media (ASOM). If not adequately treated, it progresses to chronic suppurative otitis media with attendant challenges in management. Ceasation of ear discharge is an indication of resolution of disease. The objective of this study is to appraise the value of local ear suction toileting and dressing in the ceasation of ear discharge in acute suppurative otitis media. Materials and Method: Consecutive new cases of acute suppurative otitis media seen at the Ear, Nose and Throat clinic of a tertiary health centre in north western Nigeria were assessed for efficacy of aural toileting and dressing with antibioctic impregnated guaze in the treatment of acute suppurative otitis media and compared with patients with similar disease without aural toileting and dressing or dressing with normal saline soaked guaze in addition to systemic antibiotic and antihistamine medications. Ear toileting was done by suctioning the discharge with suction machine, and cleaning the external auditory canal with hydrogen peroxide and methylated spirit. They were then dressed with gauze impregnated with antibiotic ear drops daily until there was no more ear discharge. The period of ceasation of ear discharge in each group was assessed. Results: There were 39 patients with acute suppurative otitis media (ASOM). Eighteen were females (46.2%) while 21 were males (53.8%), giving M:F ratio 1:2.1. Their ages ranged between 1 month and 45 years. About 36 (92.3%) were children and out of this, 28 (77.8%) were less than 5 years old. The average period of ceasation of discharge was 24-48 hours with those undergoing ear toileting and dressing but varied between 7 and 10 days with those without ear dressing or dressing with normal saline soaked guaze. This finding compelled us to stop the study * Corresponding author.

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Section: Discussionmentioning

confidence: 99%

Aural Toileting and Dressing—Important Intervention Measures in the Management of Acute Suppurative Otitis Media

Iseh¹,

Amutta²,

Abdullahi³

et al. 2014

IJOHNS

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“…Dekker (1991) described sump-lling of ointment by a syringe and suction tip, which provides continuous contact of the medication and does not require frequent reviews. 7,8 However, this reduces hearing temporarily, and staged removal is often necessary.…”

Section: Discussionmentioning

confidence: 99%

Randomized trial on the treatment of oedematous acute otitis externa using ear wicks or ribbon gauze: clinical outcome and cost

2002

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Acute otitis externa is a common condition that can be extremely painful. When there is considerable canal oedema, packing is necessary to facilitate the passage of medication. The experience at the Royal Victoria Eye and Ear Hospital is that ear wicks generally require removal in two to three days by medical staff and can be labour intensive as they often involve serial removals following re-insertions. Alternatively, medicated ribbon gauze is cheap and can be removed by the patient at home. Ear wick and mediated ribbon gauze were investigated by a prospective randomized trial involving 94 patients. Fewer out-patient visits were required for the ribbon gauze group (two vs. three, p<0.0001) with considerably less material and labour costs than the wick group. Similar resolution rates were achieved (70 per cent vs. 64 per cent, p = 0.58). Following development of guidelines, the proportion of otitis externa patient reviews in the accident and emergency department declined from 49 per cent to 36 per cent. Compared with the ear wick, medicated ribbon gauze is a cost-effective method of treating oedematous acute otitis externa.

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“…In addition, Wilde et al (182) reported using TAC ointment, consisting of topical triamcinolone (0.1%), gramicidin (0.025%), neomycin (0.25%) and nystatin, to fill the entire middle ear cavity or to impregnate ribbon gauze which was packed into the ear. Mahoney used ear wicks impregnated with alum acetate in a mass treatment of draining ears in Zaire (107).…”

Section: Topical Antiseptics May Be As Effective As Topical Antibioticsmentioning

confidence: 99%

“…The physical properties of these topical antimicrobials may be just as important as their antimicrobial actions. Several authors (85,153,182) pointed out the importance of prolonged contact of the agent with the middle ear mucosa so that ointments, powders and suspensions are preferable to plain solutions. The local drying effect of antibiotic powder on weeping middle ear cavities is widely recognized and seems to be independent of any specific antimicrobial activity (95).…”

Section: Topical Antiseptics May Be As Effective As Topical Antibioticsmentioning

confidence: 99%

Relationship between size and site of tympanic membrane perforations and pure tone audiometry results

Naseema¹,

Ravindran²,

Santhi³

2022

J Med sci Res.

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Background: Chronic otitis media is a condition commonly presenting with tympanic membrane perforation and resulting in conductive hearing loss. The aim of the study was to assess the relationship between the site and size of tympanic membrane perforation with the degree of hearing impairment in patients with inactive chronic otitis media of mucosal type. Methods: Hospital based cross sectional study of 174 patients with tympanic membrane perforation at government medical college, Alappuzha from November 2017 to March 2019. Patients were enrolled based on history and clinical examination findings. Images obtained by otoendoscopy were analyzed by measuring the percentage area of membrane perforation in relation to total area of the tympanic membrane using adobe acrobat area tool. Degree of hearing loss was calculated by pure tone audiometry test and calculating the average hearing thresholds at frequencies of 500Hz, 1000Hz, 2000Hz and 4000Hz. Results: The age distribution of patients ranged from 14 to 72 years with a mean age of 41.78years. Male to female ratio was 1.59:1. The degree of hearing loss increased as the size of the perforation increased which was statistically significant (p <0.001). Posterior quadrant perforations resulted in more hearing impairment than anterior quadrant perforations. Conclusion: The size of the tympanic membrane perforation is closely related to the degree of hearing loss and posterior quadrant perforations have more degree of hearing impairment than anterior quadrant perforations which signifies improvement in hearing in patients with chronic otitis media by reconstructive surgeries, especially for perforations involving the posterior quadrant.

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An alternative to regular dressings for otitis externa and chronic supperative otitis media?

Cited by 17 publications

References 4 publications

Aural Toileting and Dressing—Important Intervention Measures in the Management of Acute Suppurative Otitis Media

Aural Toileting and Dressing—Important Intervention Measures in the Management of Acute Suppurative Otitis Media

Randomized trial on the treatment of oedematous acute otitis externa using ear wicks or ribbon gauze: clinical outcome and cost

Relationship between size and site of tympanic membrane perforations and pure tone audiometry results

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