Management of myringitis: Current concepts and review

This study reviews the proposed mechanisms underlying the development of myringitis and suggests optimal guidelines for the successful treatment and prevention of recurrence through a literature review.

Studies reporting the treatment outcomes of myringitis were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from 2000 to 2017. The search for myringitis yielded 57 results, and 31 were found to be relevant. Thirteen articles related to bullous myringitis associated with acute otitis media were excluded; the remaining 18 were included in this study. The studies were reviewed with attention to clinical characteristics, treatment options, and results after treatment.

Among 18 publications, 10 suggested therapeutic options for myringitis: 1) five studies suggested management using topical agents, 2) three studies suggested laser-assisted treatment, and 3) two studies suggested surgical treatment. Treatments using topical agents or a laser showed highly variable resolution rates (63.6%-100% and 20%-85.7%, respectively). Two studies introducing surgical therapy reported good treatment outcomes (95.8%-100%). Five articles discussed the characteristics or diagnosis of myringitis; however, there was a lack of evidence for the related mechanism.

No well-designed randomized studies have assessed optimal treatments. Although surgery showed better treatment results than topical agents and laser-assisted treatment, the wide range of resolution rates indicates that proper patient selection is needed. Further studies are needed to improve the current understanding and management of myringitis. Laryngoscope, 128:2157-2162, 2018.