Abstract
Introduction: Otitis externa is a common painful condition presents with generalized infection of external auditory canal, typically reveals erythema and edema of the skin. Aural packing plays an important role in relieving the pain and edema. For packing, either we impregnated with 10% Ichthammol glycerine or steroid-antibiotic ointment.
 Objective: To compare the efficacy of 10% Ichthammol Glycerine pack with steroid-antibiotic ointment pack for relieving the pain in acute otitis externa.
 Methodology: A prospective, non-randomized clinical trial was carried out in 94 patients at Birat Medical College and Teaching Hospital, Biratnagar, Nepal from February 2018 to July 2018. Patients diagnosed with acute otitis externa were included in this study, where 47 patients were treated with 10% IG pack and remaining 47 patients treated with a combination steroid antibiotic ointment pack. Before aural packing was carried out, pain was assessed using visual analogue scale (VAS). Both groups of patients were evaluated after 48 hours for assessment of pain.
 Results: The total number of patients included in this study was 94. Among them 41 (43.6%) were male and 53(56.4%) were female where male and female ratio was 1:1.29. Majority of the patients were below 40 years (83%). Treatment with steroid-antibiotic ointment pack had significant reduction in pain after 48 hours post treatment, none of them had severe pain, 4(8.5%) had moderate pain remaining and 43(91.4%) had only mild pain. Whereas in patients treated with 10% IG pack 1(2.1%) had severe pain, 14(29.7%) had moderate pain and 32(68%) had mild pain. There was statistically significant decrease in pain with steroid-antibiotic pack.
 Conclusions: Both treatment modalities are effective but this study showed steroid-antibiotic ointment pack, the combined therapy is more effective than 10% IG pack for relieving the pain in acute otitis externa.
Highlights
O s externa is a very common condi on presents with generalized infec on of external auditory canal, typically reveals erythema and oedema of the skin
Pa ents diagnosed with acute o s externa were included in this study, where 47 pa ents were treated with 10% ichthammol glycerine (IG) pack and remaining 47 pa ents treated with a combina on steroidan bio c ointment pack
Whereas in pa ents treated with 10% IG pack 1(2.1%) had severe pain, 14(29.7%) had moderate pain and 32(68%) had mild pain
Summary
O s externa is a very common condi on presents with generalized infec on of external auditory canal, typically reveals erythema and oedema of the skin. Characteris c symptoms include pain, itching, canal oedema, aural fullness and many pa ents have discharge. 10 percent of the popula on is affected during their life me.[2] It is more common in adults but the condi on does affect children and geriatric group too. O s externa may be acute or chronic considering the me dura on. If it lasts less than six weeks, it is acute and if persists more than three months, is chronic.[3] It is classified as localised and diffuse where diffuse o s externa is predominantly common
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