Odharna Ní Dhomhnalláin, Caoimhe A. Byrne, Abdelrahman E. M. Ezzat, John E. Fenton
Background: Otitis externa (OE) is a common condition, with a prevalence of 1%. While the majority of cases are seen in the community, with rapid resolution following conventional topical therapies, a small fraction persist, requiring review by otorhinolaryngologists. Novel therapies, including topical immunomodulators like Tacrolimus, are now employed in these recalcitrant cases. In our institution, a cohort of such patients have been successfully treated with a combination of Nizoral, a Ketoconazole-containing shampoo, and topical Tacrolimus. We now report their long-term results.
Methods: These patients were retrospectively identified through a search of an individual surgeon’s clinic letters (n=24). Nizoral shampoo was used twice-weekly for 4 weeks, with instructions for nail care and maintenance therapy. Using their clinic letters, along with their charts, the self-reported symptoms, demographics, microbiology reports, number of out-patient appointments and clinical findings were recorded.
Results: Among these patients with recalcitrant chronic OE, one reported recurrence. The remaining patients are awaiting follow up or have deigned to attend.
Conclusions: Nizoral, in combination with Tacrolimus, has, in our small cohort, demonstrated long-term efficacy in the treatment of unresponsive cases of Chronic Otitis Externa. It should be considered as an adjunct to Tacrolimus, particularly when involvement of seborrhoeic dermatitis is considered as a contributing factor.
