Assistant Professor, Department of ENT, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India
Acute otitis externa, steroid-antibiotic therapy, ichthammol glycerin, ear infections, aural packing, inflammation, pain management ,

Acute otitis externa (AOE) is a common inflammatory condition of the external auditory canal, primarily caused by bacterial infections, with Staphylococcus aureus and Pseudomonas aeruginosa being the most frequently implicated pathogens. The condition is characterized by pain and swelling, necessitating effective treatment strategies. This study aimed to compare the therapeutic efficacy of steroid-antibiotic aural packing with 10% ichthammol glycerin (IG) packs in alleviating pain and reducing edema in AOE patients. Methods: A randomized study was conducted at Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India, between 2019 and 2020, involving 41 patients diagnosed with AOE. Patients were divided into two treatment groups: 10% ichthammol glycerin (IG) packs and steroid-antibiotic packs (Betnovate-N, containing betamethasone valerate and neomycin). Pain was assessed using the Numeric Rating Scale (NRS), and edema was evaluated based on the percentage of the external auditory canal affected. Follow-up evaluations were conducted every 48 hours, with repacking performed if tragal tenderness or swelling persisted. Data were analyzed using the Z-test for means to compare pain relief, edema resolution, and the number of visits required for complete recovery. Results: Patients in the steroid-antibiotic group experienced significantly faster pain relief and reduction in edema compared to the 10% IG pack group. On average, steroid-antibiotic pack users required 3.5 visits, whereas 10% IG pack users needed 5.4 visits (p < 0.05). By the fourth visit, edema had significantly subsided in the steroid-antibiotic group, while it persisted until the fifth visit in the 10% IG group. The pain score was notably lower in the steroid-antibiotic group after the second visit. No adverse effects were reported in either group. Conclusion: The study findings indicate that steroid-antibiotic aural packing is more effective than 10% ichthammol glycerin therapy in managing AOE by providing faster pain relief, reducing edema, and minimizing the number of medical visits required. Given these benefits, steroid-antibiotic therapy should be considered a preferred treatment option for acute otitis externa.

10 , 2 , 2020