Efficacy of diluted vinegar in treating granular myringitis: a randomised controlled trial

Abstract

Objective This study aimed to evaluate the outcome of granular myringitis treatment of 1 per cent diluted vinegar ear drops or 1 per cent chloramphenicol ear drops and to assess the side effects of 1 per cent diluted vinegar. Method Twenty-four patients aged over 18 years and diagnosed with granular myringitis grade I or II within 90 days of symptom onset were included. Patients were equally randomised into either the 1 per cent diluted vinegar group or the 1 per cent chloramphenicol group. Outcome of treatment and side effects were compared between groups. The main outcome measure was completely epithelialised tympanic membrane at the eight-week period. Results Eleven of 12 patients treated with 1 per cent diluted vinegar had complete recovery. In the 1 per cent chloramphenicol group, 8 of 12 patients recovered. The difference between groups was not statistically significant (p = 0.156). The observed side effects of diluted vinegar included dizziness and mild external auditory canal irritation. Conclusion One per cent diluted vinegar is an interesting option for granular myringitis. Other comparative advantages of 1 per cent diluted vinegar include its low price and no induction of antimicrobial resistance.

Effectiveness of 1 and 2 per cent acetic acid solutions in the 2-week treatment of granular myringitis

“…Prakairungthong et al . 16 found that a 1 per cent acetic acid solution effectively treated granular myringitis compared with antibiotic eardrops. Nevertheless, we wondered if any regimen could reduce the treatment duration.…”

“…The sample size was calculated using reference proportions from studies by Taneja 15 and Prakairungthong et al 16 The reference success rates for the 1 and 2 per cent acetic acid solutions at 2 weeks were 40 per cent and 81 per cent, respectively. The significance level was set at 0.05 with a test power of 80 per cent.…”

“…A randomised, controlled trial 16 on granular myringitis treatment was conducted in 2020. The researchers compared a 1 per cent acetic acid solution and chloramphenicol eardrops, measuring their outcomes at 8 weeks.…”

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“…Many treatment modalities have been proposed over the past 20 years for treatment of chronic myringitis, including irrigation with diluted vinegar, antiseptics or anti-biotics, laser ablation and surgical excision [5][6][7][8][9][10][11][12][13]. A Systemic review by Chung et al in 2018 reported treatment success with topical agents ranged from 63.6% to 100% [5].…”

“…The first randomized controlled trial comparing different treatment modalities was performed by Prakairungthong et al in 2021 [6]. They compared treatment with diluted vinegar irrigation versus chloramphenicol ear drop in 24 patients.…”