Change of External Auditory Canal pH in Acute Otitis Externa

Abstract

Objectives:We investigated 1) the correlation between the degree of acute otitis externa (AOE) and a change of pH and 2) the recovery of pH after acidification compared to an antibiotic otic solution in AOE. A change of pH in the external auditory canal (EAC) is very important for the pathogenesis of otitis externa. Therefore, not only an antibiotic otic solution, but also acidification, is known to be a good treatment for AOE. However, pH has only been investigated in chronic otitis externa, and not in AOE. Methods: This was a prospective randomized control study. Forty adult patients (56 ears) with AOE and 40 normal control subjects (80 ears) participated in this study. The severity of disease was graded as mild, moderate, or severe. The pH of each EAC was then measured. The patients were randomly assigned into 2 groups: one for vinegar irrigation and the other for topical antibiotics. The pH of the diseased ears was measured at 1 and 2 weeks after the treatment. Results: The mean (±SD) pH for the normal control subjects was 5.4 ± 0.48, and the EAC lost its acidity proportionately to the degree of disease (p < 0.05). For both the vinegar irrigation and topical antibiotic groups, the acidity was restored dramatically (p < 0.05) at 1 and 2 weeks for the moderate and severe grades of otitis, but not for the mild grade. There was no difference in recovery between the 2 groups. Conclusions: The EAC lost its acidity proportionately to the degree of disease in AOE. Vinegar irrigation and topical antibiotics were equally effective for restoration of pH.

Arytenoid abduction for bilateral vocal fold immobility

“…AAb has been reported in 11 patients with bilateral paralysis [21 ]. The most common cause was thyroidectomy (five patients).…”

Comparison of Ventilation and Voice Outcomes between Unilateral Laryngeal Pacing and Unilateral Cordotomy for the Treatment of Bilateral Vocal Fold Paralysis

“…Reversible treatment options include the previously mentioned tracheostomy, endo-extralaryngeal suture lateralization as popularized by Lichtenberger and Toohill [8], or laryngeal botox injection in carefully selected cases [9]. Long-term, permanent surgical solutions include endoscopic laser arytenoidectomy [10], endoscopic partial arytenoidectomy [11], arytenoid abduction [12, 13], posterior cordotomy [9], and laryngeal selective reinnervation [15–18]. A number of the new techniques appear to be promising: arytenoid abduction has been performed urgently in patients in place of a tracheostomy with dramatic airway improvement [13].…”

“…Long-term, permanent surgical solutions include endoscopic laser arytenoidectomy [10], endoscopic partial arytenoidectomy [11], arytenoid abduction [12, 13], posterior cordotomy [9], and laryngeal selective reinnervation [15–18]. A number of the new techniques appear to be promising: arytenoid abduction has been performed urgently in patients in place of a tracheostomy with dramatic airway improvement [13]. As well, selective reinnervation for BVFP has been described in animal [16, 19] and cadaver models [20], yet human studies are sparse due to the variability and complexity of the nerve supply and the procedure [17].…”

Airway obstruction due to unilateral vocal fold paralysis

“…Therefore, arytenoid abduction (AAb), a procedure that mimics the action of the PCA muscle, should relieve airway obstruction due to arytenoid prolapse. AAb has been reported to improve the airway in patients with bilateral laryngeal paralysis 5, 6. The surgical exposure for AAb is essentially the same as for arytenoid adduction (AAd); however, the anchoring suture generates a different vector of force on the muscular process.…”