Abstract
Acute otitis externa is a common clinical condition accounting for a large proportion of patients attending the otolaryngology department, although milder cases are often managed in primary care. Treatment of the most severe forms of otitis externa involves aural toilet, followed by the application of a topical preparation, commonly in the form of an ear canal dressing. A prospective single-blind randomized controlled trial was performed to compare the efficacy of 10% glycerine–ichthammol (GI) solution and Triadcortyl® (TAC) ointment, both applied as ear canal dressings, in the initial management of severe acute otitis externa. A total of 64 patients were studied. Both treatment modalities were proven efficacious in the treatment of severe acute otitis externa. Although there was a statistically significant improvement of pain parameters in the TAC group, we found no significant differences in clinical findings between the two groups. Therefore, it is recommended that GI dressing can be used instead of an antibiotic dressing as an initial treatment of severe acute otitis externa on the basis of cost, avoidance of resistance and toxicity.
Similar content being viewed by others
References
Rowlands S, Devalia H, Smith C, Hubbard R, Dean A (2001) Otitis externa in UK general practice: a survey using the UK General Practice Research Database. Br J Gen Pract 51:533–538
Hawke M, Wong J, Krajden S (1984) Clinical and microbiological features of otitis externa. J Otolarygol 13:289–295
Agius AM, Pickles JM, Burch KL (1992) A prospective study of otitis externa. Clin Otolaryngol 17:150–154
Raza SA, Denholm SW, Wong JCH (1995) An audit of the management of acute otitis externa in an ENT casualty clinic. J Otolarygol 109:130–133
Rosenfeld RM, Brown L, Cannon CR, Dolor RJ, Ganiats TG, Hannley M, Kokemueller P, Marcy SM, Roland PS, Shiffman RN, Stinnett SS, Witsell DL, American Academy of Otolaryngology–Head, Neck Surgery Foundation (2006) Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg 134:4–23
Bojrab DI, Bruderly T, Abdulrazzak Y (1996) Otitis externa. Otolaryngol Clin North Am 29:761–782
McDowall GD (1974) External otitis: otological problems. J Laryngol Otol 88:1–13
Peterkin GA (1974) Otitis externa. J Laryngol Otol 88:15–21
Wilde AD, England J, Jones A (1995) An alternative to regular dressings for otitis externa and chronic supperative otitis media? J Laryngol Otol 109:101–103
Ahmed K, Roberts ML, Mannion PT (1995) Antimicrobial activity of glycerine–ichthammol in otitis externa. Clin Otolaryngol 20:201–203
Caruso VG, Meyerhoff WL (1980) Trauma and infection of the external ear. In: Paparella M, Shumrick D (eds) Otolaryngology, vol II. W.B. Saunders Company, Philadelphia, pp 1345–1348
Hicks SC (1983) Otitis externa: are we giving adequate care? J R Coll Gen Pract 33:581–583
Russell JD, Donnelly M, McShane DP et al (1993) What causes otitis externa? J Laryngol Otol 107:898–901
Nilssen E, Wormald PJ, Oliver S (1996) Glycerol and ichthammol: medicinal solution or mythical potion? J Otolarygol 110:319–321
Williamson DS (1979) Topical therapy. In: Rook A, Williamson DS, Ebling FJG (eds) Textbook of dermatology. Blackwell, Oxford, pp 2293–2328
Czarnetzki BM (1996) Inhibitory effects of shale oils (ichthyols) on the secretions of chemotactic leukotrienes from human leukocytes and on leukocyte migration. J Invest Dermatol 87:694–697
Hajioff D (2005) Otitis externa. Clin Evid 14:1–2
Meenan FOC (1988) A double-blind comparative study to compare the efficacy of Locoid C with tri-adcortyl in children with infected eczema. Br J Clin Pract 42:200–202
Tsikoudas A, Jasser P, England RJA (2002) Are topical antibiotics necessary in the management of otitis externa? Clin Otolaryngol 27:260–262
Clayton MI, Osborne JE, Rutherford D et al (1990) A double-blind randomised prospective trial of a topical antiseptic versus a topical antibiotic in the treatment of otorrhoea. Clin Otolaryngol 15:7–10
Smith IM, Keay DG, Buxton PK (1990) Contact hypersensitivity in patients with chronic otitis externa. Clin Otolaryngol 15:155–158
Kime CE, Ordonez GE, Updegraff WR (1978) Effective treatment of acute diffuse otitis externa: II. A controlled comparison of hydrocortisone-acetic acid, non-aqueous and hydrocortisone-neomycin-colistin otic solutions. Curr Ther Res 23:15–28
Matz G, Rybak L, Roland PS, Hannley M, Friedman R, Manolidis S, Stewart MG, Weber P, Owens F (2004) Ototoxicity of ototopical antibiotic drops in humans. Otolaryngol Head Neck Surg 30:79–82
Manolidis S, Friedman R, Hannley M, Roland PS, Matz G, Rybak L, Stewart MG, Weber P, Owens F (2004) Comparative efficacy of aminoglycoside versus fluoroquinolone topical antibiotic drops. Otolaryngol Head Neck Surg 130:83–88
Halpern MT, Palmer CS, Seidlin M (1999) Treatment patterns for otitis externa. J Am Board Fam Pract 12:1–7
Kaushik V, Malik T, Saeed SR (2005) Interventions for otitis externa. (Cochrane review). In: The Cochrane Library, Issue 3. Wiley, New York, pp 1–7
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Masood, A., Moumoulidis, I., Ray, S. et al. A randomised controlled trial comparing Triadcortyl® with 10% glycerine–ichthammol in the initial treatment of severe acute otitis externa. Eur Arch Otorhinolaryngol 265, 881–885 (2008). https://doi.org/10.1007/s00405-007-0463-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-007-0463-1