Discharge from the ear: otitis externa and acute otitis media.

Ludman, Harold

doi:10.1136/bmj.281.6255.1616

Cited by 12 publications

(13 citation statements)

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“…On the other hand most otolaryngologists recommend topical antibiotic therapy and point out the poor penetration by most antibiotics into a devascularized middle ear mucosa masked with subepithelial scarring and thickening [4,12,13].…”

Section: Discussionmentioning

confidence: 99%

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Role of Acetic Acid Irrigation in Medical Management of Chronic Suppurative Otitis Media: A Comparative Study

Gupta

Agrawal

Gargav

2014

Indian J Otolaryngol Head Neck Surg

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Chronic otitis media is persistent and insidious disease. It is one of the most common bacterial infections in the field of otolaryngology having significant economic and individual repercussion. Medical management of chronic suppurative otitis media (CSOM) for dry ear is essential before surgical treatment. The objective is to consider the most appropriate medical treatment modalities for patients of CSOM. To assess results of acetic acid irrigation and topical and systemic antibiotic in CSOM and consider, the most appropriate medical management. This study was conducted prospectively from Nov 2011 to Sep 2013 in 100 patients of CSOM (tubotympanic type). Patient included in the present study were divided in two groups. In one group patients were treated with aural toilet and irrigation with acetic acid and in other group patients were treated with topical and systemic antibiotic. After a follow up period of 3 months duration results were assessed on the basis of absence of discharge, healing of perforation and status of middle ear. Otorrhoea resolution in group treated with acetic acid was 84 % and healing of perforation was noted in 26 % while failure rate of 16 % was noted. In group treated with topical and systemic antibiotic 58 % of patient shows otorrhoea resolution, 14 % achieve healing of perforation and 32 % had failure. Medical management of CSOM without Cholesteatoma by frequent aural cleaning and irrigation using dilute acetic acid can be more desirable choice as compared to the topical and oral antibiotics.

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Section: Discussionmentioning

confidence: 99%

“…However, there is general agreement that aural toilet must be part of the standard medical treatment for CSOM [4].…”

Section: Introductionmentioning

confidence: 99%

Role of Acetic Acid Irrigation in Medical Management of Chronic Suppurative Otitis Media: A Comparative Study

Gupta

Agrawal

Gargav

2014

Indian J Otolaryngol Head Neck Surg

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Section: Discussionmentioning

confidence: 99%

“…Aural toileting has been reported widely in chronic suppurative otitis media and only very few people have talked about it for treatment of ASOM [18]. There is general agreement that aural toileting must be part of the standard treatment for chronic suppurative otitis media [18]. Cleaning the ear of mucoid discharge could reduce, even if temporarily, the quantity of infected material from the middle ear and could facilitate middle ear penetration of topical anti-microbial [18].…”

Section: Discussionmentioning

confidence: 99%

“…There is general agreement that aural toileting must be part of the standard treatment for chronic suppurative otitis media [18]. Cleaning the ear of mucoid discharge could reduce, even if temporarily, the quantity of infected material from the middle ear and could facilitate middle ear penetration of topical anti-microbial [18]. Eason et al [19] observed that 50% of 26 ears of school children studied became dry with aural toileting alone.…”

Section: Discussionmentioning

confidence: 99%

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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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