慢性穿孔性中耳炎，慢性鼓膜炎，慢性外耳道炎に対するブロー液の有用性について

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  • EFFICACY OF BUROW'S SOLUTION IN THE TREATMENT OF CHRONIC EAR INFECTION

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Purpose : We evaluated the efficecy of Burow's solution, first produced by Burow in the 19th century and reported by Terayama et al. in 2003 to be effective in Japan against refractory otitis externa and otitis media.<BR>Materials and Methods : Subjects were 57 patients (64 ears) -25 men (27 ears) and 32 women (37 ears) ranging in age from 10 to 94 years. Their diseases included chronic perforative otitis media (30 ears), chronic myringitis (19 ears), and chronic otitis externa (15 ears). Patients were treated with Burow's solution instilled into the ear for about 10 minutes or a pledget soaked in this solution inserted into the ear. We evaluated effects on the volume of ear discharge and bacteria based on a four-grade system of “complete response, ” “remission, ” “no change, ” and “aggravation”. Subjects were divided into two groups-those with granulation and those with eardrum perforation-and evaluated based on gender surgical history, and presence or absence of staphylococcus, and compared for significant differences in treatment efficacy.<BR>Results : Complete response was seen in 9, remission in 11, no change in 9, and aggravation in 1 of 30 ears in patients with chronic perforative otitis media ; in 10, 4, 2, and 3 of 19 ears in those with chronic myringitis ; and in 13, 1, 1, and none of 15 ears in those with otitis externa. Statistical analysis of treatment efficacy among the three disease groups (chronic perforative otitis media, chronic myringitis, and chronic otitis externa) using Kruskal-Wallis test showed a significant difference (p = 0.01). Bacterial culture examinations detected bacteria and fungi in 61 ears, the most common being methicillin-susceptible staphylococcus aureus (MSSA) in 19 ears (29.7%). Statistical analysis using Mann-Whitney's U test showed p of 0.61 for gender, 0.17 for surgery, 0.02 for ear drum perforation, 0.005 for granulation, and 0.72 for staphylococcus-showing a significant difference in treatment efficacy in cases of ear drum perforation and those of granulation.<BR>Conclusions : Burow's solution is less effective in patients with ear drum perforation and with granulation, and therefore should not be used chronically in such patients.

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