Middle Ear, Tympanic Membrane, Infections Medication

  • Author: John Schweinfurth, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Mar 12, 2012
 

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.

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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.

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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.

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Acetaminophen with codeine (Tylenol #3, Ortophenum)

 

Indicated for the treatment of mild-to-moderate pain.

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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.

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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.

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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.

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Acetic acid (VoSol)

 

Works well in superficial bacterial infections of otitis externa.

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Contributor Information and Disclosures
Author

John Schweinfurth, MD  Professor, Department of Otolaryngology, University of Mississippi Medical Center

John Schweinfurth, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Laryngological Association, American Medical Association, and Triological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Yuri P Uliyanov, MD, PhD  Director, Department of Ear, Nose, and Throat, Agami Medical Center

Yuri P Uliyanov, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael E Hoffer, MD  Director, Spatial Orientation Center, Department of Otolaryngology, Naval Medical Center of San Diego

Michael E Hoffer, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: American biloogical group Royalty Other

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gerard J Gianoli, MD  Clinical Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine; Vice President, The Ear and Balance Institute; Chief Executive Officer, Ponchartrain Surgery Center

Gerard J Gianoli, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Neurotology Society, American Otological Society, Society of University Otolaryngologists-Head and Neck Surgeons, and Triological Society

Disclosure: Vesticon, Inc. None Board membership

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Medvoy Ownership interest Management position; Cerescan Imaging Consulting; Headwatersmb Consulting fee Consulting; Venturequest Royalty Consulting

References

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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.
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).
Mirror display of a tympanic membrane surface on the polymeric masc from external acoustical canal of healthy man. Masc of tympanic membrane surface (MtmS).
 
 
 
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