![]() ![]() We are very uncertain whether there is a difference at 16 weeks (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.60 to 1.72 1 study 217 participants) because the certainty of the evidence is very low. For resolution of ear discharge after four weeks, one study reported the results per person. Neither study presented results for resolution of ear discharge at between one and up to two weeks or between two to four weeks. Two studies (351 children 370 ears) compared daily dry mopping with no treatment. None of the included studies reported the outcomes of health‐related quality of life, ear pain or the adverse event of ear bleeding.ĭaily aural toileting (dry mopping) versus no treatment Two studies included only children with CSOM in the community (351 participants) and the other study (80 participants) included children and adults with chronic ear discharge for at least six weeks. We included three studies with a total of 431 participants (465 ears), reporting on two comparisons. ![]() Secondary outcomes were hearing, serious complications, and the adverse events of ear bleeding and dizziness/vertigo/balance problems. Our primary outcomes were: resolution of ear discharge or 'dry ear' (whether otoscopically confirmed or not), measured at between one week and up to two weeks, two weeks to up to four weeks, and after four weeks health‐related quality of life using a validated instrument and ear pain (otalgia) or discomfort or local irritation. We used GRADE to assess the certainty of the evidence for each outcome. We used the standard Cochrane methodological procedures. topical antiseptics or topical antibiotics) separately. We analysed trials in which background treatments were used in both arms (e.g. The comparisons were aural toileting compared with a) placebo or no intervention, and b) any other aural toileting method. We included any aural toileting method as the intervention, at any frequency and for any duration. We included randomised controlled trials (RCTs) with at least a one‐week follow‐up involving people (adults and children) who had chronic ear discharge of unknown cause or CSOM, where the ear discharge had continued for more than two weeks. The date of the search was 16 March 2020. The Cochrane ENT Information Specialist searched the Cochrane ENT Register Central Register of Controlled Trials (CENTRAL via the Cochrane Register of Studies) Ovid MEDLINE Ovid Embase CINAHL Web of Science ICTRP and additional sources for published and unpublished trials. To assess the effects of aural toilet procedures for people with CSOM. Aural toileting can be used alone or in addition to other treatments for CSOM, such as antibiotics or topical antiseptics. Compared to irrigation or microsuction it is less effective in removing epithelial debris or thick pus. Dry mopping may be effective in removing mucopurulent discharge. Techniques used may include dry mopping (with cotton wool or tissue paper), suction clearance (typically under a microscope) or irrigation (using manual or automated syringing). The predominant symptoms of CSOM are ear discharge and hearing loss.Īural toileting is a term describing a number of processes for manually cleaning the ear. Chronic suppurative otitis media (CSOM), sometimes referred to as chronic otitis media (COM), is a chronic inflammation and often polymicrobial infection (involving more than one micro‐organism) of the middle ear and mastoid cavity, characterised by ear discharge (otorrhoea) through a perforated tympanic membrane. ![]()
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