Uses of ear drops

• Anti-inflammatory
• Antibiotics
• Wax solvents e.g. sodium bicarbonate, olive oil, almond oil
  • These are as effective as the proprietary ceruminolytics, and much less likely to provoke a skin reaction
• Rarely it is necessary to use them for drowning insects - any bland liquid can be used

Application of eardrops

1. Turn the recipient ear upwards (easiest if lying down, but not always practical)
2. Straighten the ear canal by pulling the pinna upwards and backwards in an adult, or directly backwards in a child
3. Instil the drops
4. Press the tragus repeatedly over the introitus of the ear canal to encourage the drops to pass down the canal
5. If the external ear canal is very oedematous a wick or dressing may be required to carry drops past the swollen skin

Side effects of ear drops

• Dizziness may occur if drops not close to body temperature are instilled in the ear, especially one with an open mastoid cavity
  • Lateral semicircular canal is stimulated by temperature difference ('caloric effect')
• Local sensitivity
• There is a theoretical risk of ototoxicity with aminoglycoside antibiotics used topically in patients with perforated tympanic membranes
  • Most otologists will use these drops in selected cases as there is evidence continuing infection is more dangerous than the drops to hearing