[Topical immunomodulation. A milestone for the treatment of therapy-resistant noninfectious chronic external otitis?].
BACKGROUND
Recurrent exacerbation of chronic external otitis represents a special challenge for the attending physician. The goal of our study was to evaluate the effectiveness of novel topical immunomodulators acting through an anti-inflammatory, nonsteroidal mechanism.


METHODS
In a prospective study, in 33 patients an ear wick containing tacrolimus ointment (Protopic 0.1%) was inserted every 2-3 days. Altogether, the wick was changed three times. Therapeutic outcomes were assessed by reexaminations, video-otoscopy, and a standardized findings sheet.


RESULTS
Twenty-eight patients showed significant improvement of clinical symptoms, with 13 of them showing complete healing (follow-up 10-22 months). Relapses (15 cases) were associated with significantly extended symptom-free intervals and reduced numbers of further recurrent episodes.


CONCLUSIONS
Because of the safe and successful anti-inflammatory effects, topical immunomodulators represent a new alternative in chronic inflammatory stages of otherwise therapy-resistant external otitis.
Caffier
P P
PP
HNO-Klinik und Poliklinik , Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117 Berlin. philipp.caffier@charite.de
Harth
W
W
Mayelzadeh
B
B
Haupt
H
H
Scherer
H
H
Sedlmaier
B
B
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000175:diagnosis* / Q000188:drug therapy*; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D016559:Tacrolimus