Clinical characteristics of granular myringitis treated with castellani solution

Abstract

Aim of the study is to observe clinical manifestations of granular myringitis (GM) treated with castellani solution. Twenty-four patients (18 women and 6 men; mean age, 49.7 years; range, 9-77 years) diagnosed with GM and treated with castellani solution were enrolled retrospectively. Topical treatment using castellani solution with or without curettage of a granular lesion and serial otoendoscopy-aided photographic documentation of the tympanic membrane were performed. Outpatient follow-up period ranged from 3 to 72 months and the mean follow-up period was 14.4 months. GM was classified into marginal/non-marginal type and ulcerative/polypoid subtype using a new scale. According to the scale used in this study, the marginal and ulcerative GM was the predominant type of GM lesion. Bacterial cultures of ear discharges from 19 patients revealed Staphylococcus, Corynebacterium and Providencia stuartii in 12, 5, and 1 patient, respectively and no growth of bacteria in one patient. Of 24 patients, 23 showed complete resolution of GM after treatment with castellani solution. However, one patient had a persistent, small, dry, deepithelialized lesion and eight others required more than 3 months for complete recovery owing to a persistent residual lesion. There was recurrence in two patients but the lesion resolved after additional castellani treatment. Topical application of castellani solution is a simple and effective treatment for GM. This study suggests a potential of castellani solution for treatment of GM with a serial photographic documentation and novel classification scale for description of lesions. A sufficiently long follow-up period is essential to confirm a complete recovery of GM.