Has anyone used gentian violet for the management of (1) granular myringitis of the tympanic membrane (2) chronic otitis externa?
Hi Aaron
Yes, GV is a very good substance for biofilm-type ear infections. One major drawback is that it is ototoxic, but with judicious use it works really well. Stains pretty much irreversibly so try no to get any on your fingers! I also warn patients about the potential for them to spoil their bedding if the GV runs out when they are in bed. I usually recommend an old towel on their pillow for the first few nights.
BW
Dave
I have been long using gentian violet painf for dressing in otitis externa and bullous myringitis. Also i advise it for severe cases of oral moniliasis for its soothing effect and may be antifungal activity.
The only real problem is that there are no studies that show efficacy and safety. In our hospital we used GV quite a lot before it was not allowed anymore due to lack of evidence. It can be used in draining cavities as well and seems to produce some nice results. If someone has performed a study with a control group i would love to hear about it
Thank you for your replies. I have also used GV with good outcomes when I was working in the US but it is not currently used in the UK where I am now working. I am trying to get it on my formulary. To enable this, I am in the process of setting up a case series to investigate its use in draining chronic otitis externa, mastoid cavities and granular myringitis. I would be happy to collaborate...!
My use of GV is confined to recalcitrant otomycosis, where it has proved to be superior to most topical anti fungal meds available. I will be wary using it in scenario of TM perforation / persistent otorrhoea. Will be glad to collaborate with you on this series
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