Optimising the use of otowicks in otitis externa.

OBJECTIVE: Otowicks are used to treat otitis externa with significant ear canal oedema. This study investigates how well drops penetrate through to reach the deep canal and whether it is safe to leave otowicks in the canal for more than 2 days. METHODS: Sterile otowicks were inserted into mock ear canals and vertically over pseudomonas-seeded agar plates whilst gentamicin or ciprofloxacin drops were administered. The time taken for drops to penetrate through the otowick was recorded. Separately, pseudomonas-seeded otowicks were treated with saline or antibacterial drops. The penetrating drops were observed for bacterial growth on sterile agar. RESULTS: It took six drops before penetration occurred for both antibiotics. When sterile saline drops were applied to bacterially contaminated otowicks, the penetrating drops displayed bacterial growth on agar, indicating that pseudomonas penetrated through the otowick. However, when antibiotic drops were applied, penetrating drops showed no bacterial growth on the corresponding agar plate. CONCLUSION: Bacteria can penetrate otowicks but this is prevented by continuous application of antibacterial ear drops. Ear wicks need priming with six drops before starting a regimen, so that the initial dose is fully absorbed.

Measurement of body temperature by use of auricular thermometers versus rectal thermometers in dogs with otitis externa.

OBJECTIVE: To compare measurements of body temperature obtained with auricular thermometers versus rectal thermometers in dogs with otitis externa. DESIGN: Prospective study. ANIMALS: 100 client-owned dogs: 50 with and 50 without clinical evidence of otitis externa. PROCEDURE: Dogs were evaluated for the presence of otitis externa on the basis of clinical signs, otoscopic examination, and cytologic evaluation of ear exudate. Auricular and rectal temperatures were obtained simultaneously in all dogs prior to and following ear examination. RESULTS: There was a high correlation between auricular and rectal temperatures in dogs with otitis externa both prior to and after ear manipulation. Significant differences were not detected in temperature measurements among dogs with different degrees of otitis externa. CONCLUSIONS AND CLINICAL RELEVANCE: Auricular temperature readings obtained by use of an auricular thermometer in dogs with otitis externa are accurate measurements of body temperature, compared with rectal temperature measurements. Temperature measurements are reliable before and after examination of the ear canal.

Duration of antibacterial effectiveness of gentamicin ear drops in external otitis.

The recommendation of Anderson and Steele, for the use of ear drops four times a day, has not been changed since 1948. In order to re-evaluate the frequency of using ear drops, we examined the duration of the effectiveness of the antibacterial activity of gentamicin ear drops in external otitis. Seventeen patients (25 ears) with external otitis were studied. We took 18 samples from each ear at 0, 1, 2, 3, 6, 8, 10, 12 and 14 hours and measured the concentration of gentamicin on the wick and in the ear canal. We found that the concentration of gentamicin began to decrease only after 12 hours and a more significant decrease was detected after 14 hours of treatment. We have shown that the antibiotic used on the wick is effective for 12 hours. In conclusion, we recommend using ear drops twice a day on a wick as routine therapy for external otitis.

Use of infrared thermometry and effect of otitis externa on external ear canal temperature in dogs.

OBJECTIVE: To compare infrared thermometry with rectal thermometry as a method of assessing core body temperature in dogs and to assess the effect of otitis externa on external ear canal temperature (EECT). DESIGN: Prospective study. ANIMALS: 650 dogs without history or clinical signs of otitis externa and 85 dogs with recurrent or chronic otitis externa. PROCEDURE: Rectal temperature was measured, using a mercury thermometer. External ear canal temperature was measured, using an infrared tympanic thermometer. RESULTS: Measurements of body temperature at the 2 sites did not agree. Sensitivity and specificity of infrared thermometry in detecting fever, as determined by rectal thermometry, were 69.7 and 84.6%, respectively. Use of methods to predict rectal temperature from EECT did not improve the accuracy of infrared thermometry. Otitis externa significantly influenced EECT. CLINICAL IMPLICATIONS: Use of infrared thermometry as a replacement for rectal thermometry in assessing core body temperature in dogs was unsatisfactory. The 2 methods for measuring body temperature were not interchangeable in dogs.

[Pathogenetic validation of optimal antioxidant therapy in suppurative inflammatory otic diseases in children]. / Patogeneticheskoe obosnovanie ratsional'noi antioksidantnoi terapii pri gnoino-vospalitel'nykh zablevaniiakh ukha u detei.

The knowledge of cell-molecular characteristics of middle ear inflammation in children allowed the authors to suggest a beneficial effect of antioxidants in this disease. The trial of ascorbic acid, retinol and alpha-tocopherol as components of combined treatment has confirmed this hypophysis in view of high response achieved in children with middle ear purulent inflammation.

Characteristics of cerumen in diabetic patients: a key to understanding malignant external otitis?

Malignant externa otitis is a potentially fatal disease in diabetic and other immunocompromised patients. Cerumen contains defense properties that protect the patient against infection. We tested the hypothesis that patients with diabetes mellitus have abnormalities in their cerumen that affect the environment of their external auditory canals and may predispose them to malignant externa otitis.

Study on the suppressive effect of iodine-enriched egg on LT-C4 production in arachidonic acid-induced ear inflammation.

The anti-inflammatory mechanism of iodine-enriched egg was investigated in mice by means of arachidonic acid-induced ear inflammation. The lipid fraction of iodine-enriched egg was capable of suppressing the increase in ear weight induced by arachidonic acid in a dose-dependent manner. The lipid fraction was further separated into neutral and polar lipid fractions. Of these two fractions, only the neutral lipid fraction was capable of suppressing LT-C4 production in arachidonic acid inflammation. Neither the neutral nor polar lipid fractions of ordinary egg, however, showed any anti-inflammatory effect. These results suggest that the anti-inflammatory activity of iodine-enriched egg is present in the neutral lipid fraction, and its mechanism is assumed to be inhibition of LT-C4 production.

Granulation tissue concentrations of ofloxacin after oral administration in invasive external otitis.

Following the fourth dose of 400 mg orally administered ofloxacin, simultaneous external ear canal granulation tissue and serum ofloxacin concentrations were estimated in 15 patients with invasive external otitis. The granulation tissue concentration was 2.2 (range 1.17-4.34) times higher than the serum concentration and 3.73 (range 1.95-11.00) times higher than the MIC90 of ofloxacin against Pseudomonas aeruginosa.

Do patients with otitis externa produce biochemically different cerumen?

As polyunsaturated fatty acids have better antibacterial properties than saturated fatty acids, the cerumen of seven patients with recurrent otitis externa and seven unaffected subjects was analysed to determine their ratio. There was no significant difference in either the overall ratio of unsaturated/saturated fatty acids or in the amounts of the individual fatty acids from the cerumen of either group.

Pharmacological profile of SK&F 105809, a dual inhibitor of arachidonic acid metabolism.

The effects of SK&F 105809, 6,7,-dihydro-2-[4(methylsulfinyl) phenyl]-3-(4-pyridyl) -5[H]-pyrrolo[1,2-a] imidazole, on eicosanoid metabolism, inflammatory responses, algesia and ulcer formation are described. SK&F 105809 was determined to be a prodrug for the sulfide metabolite SK&F 105561 which is an inhibitor of 5-lipoxygenase (5-LO) and prostaglandin H (PGH) synthase activities seen with both the isolated enzyme (IC50S 3 microM) and human monocyte production of the eicosanoids leukotriene B4 (LTB4, IC50 1.0 microM) and prostaglandin E2 (PGE2, IC50 0.1 microM). In-vivo conversion of SK&F 105809 to the active principle SK&F 105561 was observed in both mice and rats. SK&F 105809 inhibited LTB4 and PGE2 production in vivo in inflammatory exudates as well as the production of LTB4 and thromboxane B2 (TxB2) ex vivo in rat blood. SK&F 105809 inhibited oedema and inflammatory-cell infiltration in arachidonic acid-induced inflammation in the mouse ear and rat paw as well as in carrageenan- and monosodium urate crystal-induced peritonitis. SK&F 105809 was also effective in inhibiting mouse collagen-induced arthritis and associated acute-phase reactant protein. At the same time, these acute and chronic models of inflammation were found to be resistant to the action of selective cyclooxygenase inhibitors such as naproxen. In addition, SK&F 105809 possessed analgesic activity in phenylquinone-induced abdominal constriction assay and inhibited indomethacin-induced ulcers.

The epidermis of the drumhead in some otologic conditions.

In a study of the behavior of the keratin layer of the drumhead epidermis in some otologic conditions, a marker dye was applied to the tympanic membrane, and migration and/or desquamation of the dotted spots observed. Decelerated migration with desquamation in situ was observed during the quiescent phase of recurrent otitis externa, with or without myringitis. The same findings were observed in most cases of chronic secretory otitis media and its sequelas (retraction pockets, atrophic membranes, and scarring). The remnants of drumhead with keratotic and hyperplastic changes in the middle ear cleared themselves of the dye very slowly.