Medication Summary
Controlled studies of effective antibiotics in various countries demonstrate 80-90% efficacy. See also Otitis Media.
Myringitis is quite painful, and patients frequently request analgesics. Ortophenum, or acetaminophen with codeine (Tylenol #3), is commonly prescribed. See also Otitis Media; External Ear Infections; External Ear, Malignant External Otitis; and External Ear, Inflammatory Diseases.
Good results occur with use of acidifying agents such as acetic acid solution. See External Ear Infections; External Ear, Malignant External Otitis; and External Ear, Inflammatory Diseases.
Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who experience pain.
Diclofenac (Cataflam, Voltaren)
Has anti-inflammatory, antipyretic, and analgesic effects. In terms of anti-inflammatory and antipyretic activity, this is much stronger than salicylic acid derivatives, ibuprofen, and butadionum.
Acetaminophen with codeine (Tylenol #3, Ortophenum)
Indicated for the treatment of mild-to-moderate pain.
Keratolytic agents
Class Summary
These agents cause cornified epithelium to swell, soften, macerate, and then desquamate. CAUTION: Any use of ototopical medications should be used with the knowledge of whether a tympanic membrane perforation exists and whether the medication has any ototoxic potential.
Salicylic acid topical
May be used as local antiseptic and keratolytic with some benefit. By dissolving the intercellular cement substance, salicylic acid produces desquamation of the horny layer of skin, while not affecting the structure of the viable epidermis.
Acidifying agents
Class Summary
These agents lower pH levels, which makes the environment unfavorable to microbial growth. CAUTION: Any use of ototopical medications should be used with the knowledge of whether a tympanic membrane perforation exists and whether the medication has any ototoxic potential.
Acetic acid (VoSol)
Works well in superficial bacterial infections of otitis externa.
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Tympanic membrane (TM) as continuation of the upper wall of external auditory canal (EAC) with angle of incline up to 45 degrees on the border between middle ear and the EAC.
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Normal tympanic membrane. Pars tensa (PT), pars flaccida (PF), light reflex (LR), fibrous ring (FR), umbo (Um), handle of malleus (HM), lateral process of malleus (Lpm), anterior plica (AP), posterior plica (PP).
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Mirror display of a tympanic membrane surface on the polymeric masc from external acoustical canal of healthy man. Masc of tympanic membrane surface (MtmS).
