Amani Soroush, Moeini Mohammad
Otolaryngologist, Department of Otolaryngology, Kashani Hospital, Shahrekord University of Medical Sciences , Shahrekord, Iran .
General Practitioner, Faculty of Medicine, Kashani Hospital, Shahrekord University of Medical Sciences , Shahrekord, Iran .
J Clin Diagn Res. 2016 Jul;10(7):MC01-4. doi: 10.7860/JCDR/2016/17175.8073. Epub 2016 Jul 1.
Acute otitis externa is an inflammation of the external auditory canal known as "swimmer's ear". Direct costs including medical treatment, painkillers, antibiotics, steroids or both and indirect costs are also remarkable.
The aim of this study was to compare the effect of boric acid and polymyxin, neomycin and hydrocortisone composition in the treatment of acute otitis externa.
This randomized clinical trial was carried out on 80 patients aged more than 17-year-old who were referred to Kashani hospital clinic with a diagnosis of acute otitis externa by otolaryngologist. The patients were randomly allocated to two groups (A: Boric acid and B: polymyxin NH ear drops) and Painkiller was prescribed and administered orally for all patients and in the presence of fever, cellulitis around the ears and neck adenopathy, broad-spectrum systemic antibiotics were used besides topical treatment. Symptoms of patients who were evaluated by a physician includes pain, discharge from the ear, swelling of the ear canal, auricle swelling, tenderness, and ear itching. In addition, pain was evaluated in patients and was recorded by Macgill Pain Questionnaire, in the first, third, seventh and tenth days.
Results showed that itching on third day (p=0.007) and swelling of the ear canal in the examination of the third day (p=0.006) and the seventh day (p=0.001) in the polymyxin NH group was more than those of boric acid group. Overall mean pain based on McGill questionnaire was 11.10±1.49 in boric acid group in the examination on the first day and was 4.05±0.22 in the examination on the tenth day and in the polymyxin NH group, it was 10.9±0.99 on the first day and 4.20±0.40 on the tenth day. In both groups, pain relief was the same and there was no significant difference between two groups (p=0.075).
The findings of this study showed slight differences in the effectiveness of the boric acid drug and combination of polymyxin, neomycin and hydrocortisone in the treatment of patients with acute otitis externa that is of clinical significance.
急性外耳道炎是外耳道的一种炎症，被称为“游泳者耳炎”。包括医疗、止痛药、抗生素、类固醇或两者兼有的直接成本以及间接成本也相当可观。
本研究的目的是比较硼酸与多粘菌素、新霉素和氢化可的松组合物在治疗急性外耳道炎中的效果。
这项随机临床试验对80名年龄超过17岁的患者进行，这些患者由耳鼻喉科医生转诊至卡沙尼医院诊所，诊断为急性外耳道炎。患者被随机分为两组（A组：硼酸；B组：多粘菌素NH滴耳液），所有患者均口服止痛药，若出现发热、耳部周围蜂窝织炎和颈部淋巴结病，除局部治疗外还使用广谱全身抗生素。医生评估的患者症状包括疼痛、耳部流脓、耳道肿胀、耳廓肿胀、压痛和耳部瘙痒。此外，在第1天、第3天、第7天和第10天对患者的疼痛进行评估，并通过麦吉尔疼痛问卷进行记录。
结果显示，多粘菌素NH组在第3天的瘙痒（p = 0.007）以及第3天（p = 0.006）和第7天（p = 0.001）检查时的耳道肿胀比硼酸组更严重。根据麦吉尔问卷，硼酸组在第1天检查时的总体平均疼痛为11.10±1.49，在第10天检查时为4.05±0.22；在多粘菌素NH组，第1天为10.9±0.99，第10天为4.20±0.40。两组的疼痛缓解情况相同，两组之间无显著差异（p = 0.075）。
本研究结果表明，硼酸药物与多粘菌素、新霉素和氢化可的松组合物在治疗急性外耳道炎患者的有效性方面存在细微差异，具有临床意义。
