External auditory canal pH in chronic otitis externa

Devesa, Pablo; Willis, Carolyn M.; Capper, J. W. R.

doi:10.1046/j.1365-2273.2003.00713.x

Cited by 37 publications

(24 citation statements)

References 19 publications

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“…A higher pH of the skin (more alkaline) has been implemented as a local risk factor in the breakdown of this barrier. 9 However, this does not explain why certain ear groups (such as ears with mastoid cavities, perforated tympanic membranes and hearing aids) are more predisposed to infection and discharge.…”

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confidence: 99%

Relative humidity of the external auditory canal in normal and abnormal ears, and its pathogenic effect

Gray

Sharma

Vowler

2005

Clinical Otolaryngology

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mentioning

confidence: 99%

Relative humidity of the external auditory canal in normal and abnormal ears, and its pathogenic effect

Gray

Sharma

Vowler

2005

Clinical Otolaryngology

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“…Moreover, orally administered antibiotics have significant adverse effects that include rashes, vomiting, diarrhea, allergic reactions, altered nasopharyngeal flora, and development of bacterial resistance. 20,107,111,112 Societal consequences include direct transmission of resistant bacterial pathogens in homes and child care centers. 19 Despite the well-demonstrated safety and efficacy of topical preparations for treating AOE, about 20% to 40% of subjects with AOE nonetheless receive oral antibiotics, often in addition to topical antimicrobials.…”

Section: Efficacy Of Topical Therapymentioning

confidence: 99%

Clinical Practice Guideline: Acute Otitis Externa

Rosenfeld

Schwartz

Cannon

et al. 2014

Otolaryngol.--head neck surg.

134

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Objective. This clinical practice guideline is an update and replacement for an earlier guideline published in 2006 by the American Academy of Otolaryngology-Head and Neck Surgery Foundation. This update provides evidence-based recommendations to manage acute otitis externa (AOE), defined as diffuse inflammation of the external ear canal, which may also involve the pinna or tympanic membrane. The variations in management of AOE and the importance of accurate diagnosis suggest a need for updating the clinical practice guideline. The primary outcome considered in this guideline is clinical resolution of AOE.Purpose. The primary purpose of the original guideline was to promote appropriate use of oral and topical antimicrobials for AOE and to highlight the need for adequate pain relief. An updated guideline is needed because of new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group. The target patient is aged 2 years or older with diffuse AOE. Differential diagnosis will be discussed, but recommendations for management will be limited to diffuse AOE, which is almost exclusively a bacterial infection. This guideline is intended for primary care and specialist clinicians, including otolaryngologists-head and neck surgeons, pediatricians, family physicians, emergency physicians, internists, nurse practitioners, and physician assistants. This guideline is applicable in any setting in which patients with diffuse AOE would be identified, monitored, or managed.Action Statements. The development group made strong recommendations that (1) clinicians should assess patients with AOE for pain and recommend analgesic treatment based on the severity of pain and (2) clinicians should not prescribe systemic antimicrobials as initial therapy for diffuse, uncomplicated AOE unless there is extension outside the ear canal or the presence of specific host factors that would indicate a need for systemic therapy. The development group made recommendations that (1) clinicians should distinguish diffuse AOE from other causes of otalgia, otorrhea, and inflammation of the external ear canal; (2) clinicians should assess the patient with diffuse AOE for factors that modify management (nonintact tympanic membrane, tympanostomy tube, diabetes, immunocompromised state, prior radiotherapy); (3) clinicians should prescribe topical preparations for initial therapy of diffuse, uncomplicated AOE; (4) clinicians should enhance the delivery of topical drops by informing the patient how to administer topical drops and by performing aural toilet, placing a wick, or both, when the ear canal is obstructed; (5) clinicians should prescribe a non-ototoxic preparation when the patient has a known or suspected perforation of the tympanic membrane, including a tympanostomy tube; and (6) clinicians should reassess the patient who fails to respond to the initial therapeutic option within 48 to 72 hours to confirm the diagnosis of diffuse AOE and to exclude other causes of illness. Keyw...

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“…The pH of the EAC was measured approximately 5 mm inside the orifice with a pH meter (pH900 FG, CK Electronic, Cologne, Germany) according to the method of Martinez-Devesa et al 3 The patients visited the hospital 3 times during the study: before the treatment and at 1 and 2 weeks after the treatment. The patients were divided randomly into 2 groups: 1 group for vinegar irrigation and the other for topical antibiotic use.…”

Section: Methodsmentioning

confidence: 99%

Change of External Auditory Canal pH in Acute Otitis Externa

Kim¹,

Cho²

2010

Ann Otol Rhinol Laryngol

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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.

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External auditory canal pH in chronic otitis externa

Cited by 37 publications

References 19 publications

Relative humidity of the external auditory canal in normal and abnormal ears, and its pathogenic effect

Relative humidity of the external auditory canal in normal and abnormal ears, and its pathogenic effect

Clinical Practice Guideline: Acute Otitis Externa

Change of External Auditory Canal pH in Acute Otitis Externa

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