Ichthammol liquid 1% in Clobetasone 0.05% ointment

Acute otitis externa is a common clinical condition that presents with rapid onset of otalgia, fullness, otorrhea and canal oedema. Moisture in-ear canal appears to be an important predisposing factor. The most common etiological agents include Pseudomonas aeruginosa and Staphylococcus aureus. Management includes control of otalgia and elimination of infection from the ear. Precipitating factors should be avoided. The main objective of this study is to compare the efficacy of 10% ichthammol glycerol ear pack with steroid antibiotic ear pack in the treatment of acute otitis externa. Institutional Review Board (IRB) clearance was obtained, and a prospective randomised clinical trial was conducted in the ENT outpatient department of Saveetha Medical College & Hospital, Thandalam, from January 2020 to March 2020. Patients were explained about the study in detail, and consent was obtained. The patients were randomised, and 10% ichthammol glycerol pack and steroid antibiotic pack were used in alternate turns for aural packing. Pain rating was done using Numerical rating scale (NRS) before and 48 hours post-treatment and also in each subsequent hospital visit till complete subsidence of symptoms. Among the 85 patients included in the study, 42 (49.4%) were males, and 43 (50.6%) were females. Most of them belonged to the age group 31-40 years (41.2%). Tragal tenderness and external auditory canal oedema were the most common ear findings noted. In the patients treated with steroid antibiotic pack, only 2.3% of the patients had severe pain, whereas 14% had moderate pain and 83.7% had only mild pain. Whereas among those treated with 10% ichthammol glycerol pack, 9.5% of the patients had severe pain, whereas 35.7% had moderate pain and 54.8% had mild pain. On analysis, the results were statistically significant, and there was considerable pain relief with steroid antibiotic pack. Therefore, our study showed that steroid antibiotic pack is more effective in relieving the symptoms, thereby reducing the number of hospital visits when compared to 10% ichthammol glycerol pack.

Abstract licence: CC BY-NC-ND 4.0

Objective The objective of this study was to evaluate the effect of postoperative medicated mastoid cavity packing on healing outcomes following canal wall down (CWD) mastoidectomy compared to no packing. Methods This prospective observational study included 125 patients undergoing CWD mastoidectomy, matched for age and sex, and assigned to two groups. Group A (n=62) received medicated mastoid cavity packing containing ofloxacin, ornidazole, clobetasone propionate, and itraconazole on postoperative days 0, 10, and 20. Group B (n=63) received no postoperative packing. Healing outcomes were evaluated and compared between the groups on postoperative days 45, 75, and 105. A p-value of <0.05 was considered statistically significant. Results The groups were comparable in age and sex distribution. The packed group demonstrated significantly higher rates of complete epithelialization on day 45 (48.4% vs. 15.9%, p < 0.0001) and day 75 (72.6% vs. 49.2%, p = 0.007), with no difference observed by day 105. Graft uptake duration was similar between groups (76.94 days in Group A and 76.19 days in Group B). Granulation tissue, mucosal folds, and otorrhea were more frequent in the non-packed group (25.4%, 6.3%, and 4.8% vs 12.9%, 3.2%, and 3.2%, respectively) during early follow-up, though not statistically significant. Mean epithelialization time was significantly shorter in the packed group (84.0 vs. 92.8 days, p = 0.001). Conclusion Medicated mastoid cavity packing promotes earlier epithelialization following CWD mastoidectomy and is associated with a lower incidence of granulation tissue without affecting graft uptake. It offers particular benefits in low-resource settings by enhancing healing and reducing follow-up needs. Larger studies are warranted to establish standardized postoperative care protocols.

Abstract licence: CC BY

Abstract Background: Acute Otitis Externa (AOE) is diffuse inflammation of the external auditory canal. Findings show a narrowed, tender and erythematous external auditory canal. There are no concrete methods in the management of AOE. Current methods include aural toileting and application of topical agents. Betamethasone Valerate, a Corticosteroid and 0.1% w/w of drug is used most commonly. The commercially used 10% Ichthammol Glycerin solution is a mixture of pure Glycerol [C3H8O3] in a 9:1 ratio with Ichthammol. Methods: All patients presenting to the Department of Otorhinolaryngology of a Rural Hospital in South India diagnosed with AOE between were included in study. Thirty were assigned to each group. Group A had IG and Group B had BV placed in their ear canal with the help of a sterile cotton wick at 0, 24 and 48 hour. The Visual Analogue Scale and Edema Erythema Index were used as parameters of assessment. Results: The EET improvement stood at 51.31% in Group A. The EET improvement stood at 47.96% in Group B. In Group A, VAS had an improvement of 63.85%. In Group B, VAS had an improvement of 49.42%. Conclusion: The use of IG was found to be superior to BV in the management of AOE. IG provides relief from topical allergy and irritation along with reduction of edema. Since IG is cheaper and easy to procure, it can be used as a first line treatment in the management of AOE.

Abstract licence: CC BY-NC-SA 4.0