Treatment of chronic resistant otitis externa with Fluticasone
propionate (Flixonase®): initial experience
Abstract
Objective: Cases of chronic otitis externa (OE) resistant to
conventional treatment remain a significant challenge. This paper
describes our experience of utilising fluticasone propionate
(Flixonase®) drops in the treatment of such cases. Methods: We included
a series of patients with resistant chronic OE that were referred to ENT
consultant clinic between 2012 and 2014, all of whom failed to respond
to the conventional treatments. The patients were prescribed 200
micrograms of Flixonase® once daily and followed up in the clinic to
assess response to the treatment. The case notes were reviewed
retrospectively. Results: Total of 25 patients identified over 2 years.
Patients reported itching as the most common symptom (83%), and skin
changes were the most common sign identified under examination (72%).
The combination of steroid and antibiotic drops had been the most common
treatment modality prescribed. Fluticasone propionate was started a
median of 5 months after the diagnosis (range: 0-54 months) with a
median treatment duration of 3 months (range: 1-18 months). All 17
patients who attended the follow-up clinic were classified as having
been cured. Conclusions: Our findings suggest fluticasone propionate as
an exciting and potentially important modality in the treatment of
chronic OE cases, especially where all other treatment options have been
exhausted.