The Evaluation of Hypertonic Sea Water Solution in the Treatment of Patients with Chronic Acute Purulent Otitis Media

Proper visualization of the external and middle ear anatomy is considered to be crucial for correct
diagnostics and subsequent treatment. External auditory canal cleaning is especially important in
children with chronic purulent otitis media as the absence of pathologic discharge in this situation
should be taken into consideration for determining the following management of the disease.
Ear lavage with dif erent kinds of solutions is essential adjuvant option in step-by-step protocols of
conservative and surgical treatment.
Conventionally dif erent kinds of antiseptic solutions or normal saline are used for the irrigation of
the ear. However, hypertonic solution has cleaning and osmotic properties. Edema of the middle
ear mucous membrane decreases by means of solution’s absorptive characteristics, which promote
f uid ef lx from tissues and vessels.
In our study the ef iacy of marine water hypertonic solution Humar Forte was evaluated.
The solution was used for external and middle ear irrigation in children with chronic acute purulent
otitis media.
67 children with diagnosis "Сhronic acute purulent otitis media" were included in the study.
In 42 patients the irrigation of the external and middle ear/postoperative wound was performed
with the use of hypertonic marine water solution Humar Forte. In the rest patients furacin 0.2% was
applied for ear lavage.
Prominent dif erences in ef iacy, duration, and quality of treatment were observed between
two groups of patients with chronic acute purulent otitis media. The duration of irrigation rates
in experiment and control groups were 7.2 days (95% CI 6.7–7.8) vs. 8.8 days (95% CI 8.1–9.4),
consequently, p<0,01; frequency of usage rates – 3.7 times per day (95% CI 3.5–3.9) vs. 4.6 times per day (95% CI 4.2–4.9), consequently, p<0,01. After 7 days of therapy applied to patients of experiment and control groups the changes in cavities of external and middle ear/postoperative wound were evaluated by Visual Analogue Scale (VAS). The VAS scores were 1.6 (95% CI 1.4–1.8) and 3.0 (95% CI 2.6–3.4), consequently, p<0.01. Doctors’ satisfaction rate with hypertonic marine water solution Humar Forte estimated by 3 points’ scale was 3.0 whereas the same rate in control group was 0.68 points (95% СI 0.48–0.88), p<0.01. There were no hypersensitivity reactions registered in experiment group whereas in one patient from control group allergy episode with hyperemia and itching located in external ear was observed. In conclusion, the results of our study show that hypertonic marine water solution Humar Forte can be recommended as the option for adjuvant therapy in patients with chronic purulent otitis media.