Treatment of chronically infected open mastoid cavities with medical honey: a randomized controlled trial.
OBJECTIVE
To investigate the efficacy of medical honey as topical treatment of chronically discharging open mastoid cavities in comparison with conventional eardrops.


METHODS
Single-center, prospective, randomized controlled, double-dose trial of 12 weeks.


METHODS
Twenty-eight patients diagnosed as having a chronically discharging open mastoid cavity underwent medical honey gel (intervention) or conventional eardrops (control) treatment. Treatment interventions were repeated after 4 weeks.


METHODS
Visual analogue scale of ear complaints, cavity inflammation, and bacterial infection.


RESULTS
Most patients had a cavity with localized granulation. After treatment, inflammation score decreased in both groups (p < 0.05), with more pronounced inflammation-free cavities in the honey group. Honey treatment resulted in less discomfort (p < 0.001) and otorrhea (p < 0.001), even after correction for additional medication use (p < 0.05, p < 0.01). This decrease was not seen in the control group. Pain and itching did not change on treatment. Most cavities were infected with Pseudomonas species and Staphylococcus aureus. After treatment, a 23% increase of negative culture was seen with honey compared with 30% in the control group (nonsignificant). No serious adverse reactions were found.


CONCLUSIONS
Medical honey gel is a safe alternative treatment option for patients with a chronically discharging open mastoid cavity and beneficial in reducing discomfort, otorrhea, and inflammation with a bactericidal effect.
*Department of Otorhinolaryngology-Head and Neck Surgery, Maastricht University Medical Center; and †Department of Toxicogenomics, Maastricht University, Maastricht, The Netherlands.
Darius
D
Henatsch
Frederik
F
Wesseling
Jacob J
JJ
Briedé
Robert J
RJ
Stokroos
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006722:Honey; D006801:Humans; D008297:Male; D008416:Mastoid; D008417:Mastoiditis / Q000188:drug therapy*; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000188:drug therapy*; D011446:Prospective Studies
D000900:Anti-Bacterial Agents