Olive oil in ears, pre-dive?

[DocVikingo]

From a reply of mine to an earlier Diving Medicine forum thread on the topic:

(Q) Ear candles

"Has anyone tried ear candles for swimmers ear? I know some people that make them. But I was wondering if anyone has tried them to realive swimmers ear. Thanks, Mauser."

(A) "It is the conclusion of experts in the field that ear candles are not only ineffective, but dangerous: "Why Ear Candling Is Not a Good Idea (http://www.quackwatch.org/01Quackery.../candling.html)." Also see the research abstracts posted below.

Diver's with concerns about swimmer's ear are referred to DAN's "Alert Diver" magazine's latest article on the topic:

Preventing Swimmer's Ear
Doc Vikingo's Preventing Swimmer's Ear


1. "Laryngoscope. 1996 Oct;106(10):1226-9.

Ear candles--efficacy and safety.

Seely DR, Quigley SM, Langman AW.

Spokane Ear, Nose, and Throat Clinic, WA 99204, USA.

Ear candles are a popular and inexpensive alternative health treatment advocated for cerumen removal. A hollow candle is burned with one end in the ear canal with the intent of creating negative pressure and drawing cerumen from the ear. If effective, significant savings could result from the use of ear candles. This study evaluates the efficacy and safety of this alternative method for cerumen management. Tympanometric measurements in an ear canal model demonstrated that ear candles do not produce negative pressure. A limited clinical trial (eight ears) showed no removal of cerumen from the external auditory canal. Candle wax was actually deposited in some. A survey of 122 otolaryngologists identified 21 ear injuries resulting from ear candle use. Ear candles have no benefit in the management of cerumen and may result in serious injury."

2. J Laryngol Otol. 2004 Jan;118(1):1-2.
Ear candles: a triumph of ignorance over science.Ernst E.

Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK. Edzard.Ernst@pms.ac.uk

Ear candles are hollow tubes coated in wax which are inserted into patients' ears and then lit at the far end. The procedure is used as a complementary therapy for a wide range of conditions. A critical assessment of the evidence shows that its mode of action is implausible and demonstrably wrong. There are no data to suggest that it is effective for any condition. Furthermore, ear candles have been associated with ear injuries. The inescapable conclusion is that ear candles do more harm than good. Their use should be discouraged."

Regards,

DocVikingo

 

[DocVikingo]

Olive oil is an additive to fungal culture medium to grow Malassezia furfur, a yeast that causes ear infection, seborrheic dermatitis, and tinea versicolor in human. This organism is extremely hard to grow, until you cover the culture with a thin layer of olive oil. Because of this, I do not recommend olive oil as an ear drop. Lanolin (sheep's sebum) has properties like human skin oil, and likely will prevent the growth of fungus, rather than promoting it.

Hi fisherdvm,

In all fairness, it seems that you are playing a bit fast and loose with this position.

For openers, fungal-related otitis externa is rather uncommon and probably accounts for <10% of all cases of swimmer's ear. Moreover, the fungus involved is almost exclusively Aspergillus. In the extraordinarily rare event that Malassezia is the causative agent, it appears that it is M. sympodialis, not M. furfur.

If you can direct me to published research documenting swimmer's ear in humans related to M. furfur I'd be most interested.

I'll grant that since M. sympodialis and Aspergillus also are lipophilic there is room for discussion, but to the best of my knowledge there is not sufficient evidence to make any firm conclusions about olive oil promoting fungi that cause swimmer's ear.

Regards,

DocVikingo

 

[tridacna]

Louis Pasteur was jumping on the Dr. Ignaz Semmelweis bandwagon. He predated Pasteur by at least 30 years. Pasteur's advice was also treated with hostility. I do not believed that he proved this definitively. In 1910, Josephine Baker, M.D. started a program to teach hygiene to child care providers in New York. Thirty physicians sent a petition to the Mayor protesting that "it was ruining medical practice by...keeping babies well."

Off topic but interesting nonetheless.

 

[DandyDon]

Uh, yeah - back to topic: Have we had any medical professionals suggest that any oils added to ears is a good thing, or would this depend on the individual and consultation with the respective physician...?

 

[tridacna]

Then I commend you to, among other citations, Mishna Shabbat, perek bet, posuk bet. Sorry, but I do not have a Hebrew font in this WP. And I cannot remember the citation in Humash where Moshe instructs the Bnai Yisrael to keep a place outside the camp (hutz l'machena) for personal business.

Maimonides was the court physician to a muslim caliph.

I'm not sure what the connection is between the Rambam and this thread. You really think he used the Chumash as a basis for diagnosing the caliph's ills? C'mon.

In the parsha last week,, we are told, not once -- but twice, that Avraham bows down to the "Am Ha'aretz," , to express his humility and gratitude for their support (Beraishis, Perek Chuff Gimmul, Psukim Zayin and Yood Bayz). Why am I quoting this and what does it have to do with putting a little schmalz in your ear. Vreig mir. My bobbe knew best. That's what I say and I'm sticking to it. At least I'm quoting Torah and you're giving us midrash in oyz. Next, you going to tell us that your drysuit has been tested for shatnes. That I gotta see!

If that makes no sense to anyone else, that's the intent. There is no sense trying to use biblical references to justify scientific practice.

 

[tridacna]

Uh, yeah - back to topic: Have we had any medical professionals suggest that any oils added to ears is a good thing?

No. We have generated a lot of heated air so far which would undoubtedly help by being blown in each ear after a dive.

 

[muddiver]

U.S. Navy diving and the commercial diving college I managed to live through reccomened a denbromic (sp?) solution of vinigar and water. It is 1 qt. of h2o to 1 tbsp. of vinigar.

The theory is that you don't want to dry the ears out because they are naturally damp. Alcohol removes all the moisture and will result in cracking, pain and other problems. The vinigar solution held for 1 to 5 minutes will kill any bugs you pick up and leave the ear canals moist and clean.

I have never had an exterior ear infection, so I think it works.

 

[fisherdvm]

Hi fisherdvm,

In all fairness, it seems that you are playing a bit fast and loose with this position.

For openers, fungal-related otitis externa is rather uncommon and probably accounts for <10% of all cases of swimmer's ear. Moreover, the fungus involved is almost exclusively Aspergillus. In the extraordinarily rare event that Malassezia is the causative agent, it appears that it is M. sympodialis, not M. furfur.

If you can direct me to published research documenting swimmer's ear in humans related to M. furfur I'd be most interested.

I'll grant that since M. sympodialis and Aspergillus also are lipophilic there is room for discussion, but to the best of my knowledge there is not sufficient evidence to make any firm conclusions about olive oil promoting fungi that cause swimmer's ear.

Regards,

DocVikingo

Yes, I didn't do my research, just day by day common sense that's all. We treat seborrheic dermatitis with antifungal topicals (selenium, ketaconazole, etc), and some of the smelliest nastiest ears are folks with seb-psor, or seboorheic problems.

I believe that many otitis externa are multifactorial, and despite all of us wanting to blame it on one or two organisms, it frequently a combination of yeast and bacteria. I don't routinely do cultures on any otitis externa I've treated, but rather empircally.

Don't want to play the number games .... simply wanting to state a pathogen I treat daily that loves oil, especially olive oil.

 

[fisherdvm]

On the second presumption, DocVikingdo, if you actually did a smear on your otitis externa, you might be amazed at what you might find.

Did you ever wonder why they don't grow M. furfur more in otitis externa cultures?? You can not culture the yeast with routine fungal medium. You have to specifically request for promotor medium for the bug - where olive oil is added to select for the organism.

I guess tell me how many family doctor/internist/dermatologist request bacterial cuture, fungal culture, and specific culture for M. furfur, and I'll agree with your stats on the cause of otitis externa.

 

[fisherdvm]

Hi fisherdvm,For openers, fungal-related otitis externa is rather uncommon and probably accounts for <10% of all cases of swimmer's ear. Moreover, the fungus involved is almost exclusively Aspergillus. In the extraordinarily rare event that Malassezia is the causative agent, it appears that it is M. sympodialis, not M. furfur.

I guess my background as a DVM tend to lump M. furfur as the pathogen for otitis externa, as it was a common thing for us to do - staining exudate from dogs ears prior to initiating treatment. But whether you chose M. furfur or M. sympodialis - the bottom line is, we commonly see spaghetti and meatball - and label them as M. furfur on clinical KOH prep.

I think that M. furfur/ M. sympodialis might be under diagnose, unless M.D.s and D.O.s do KOH and gram stain on exudates more. But with low reimbursement, I rarely even do it anymore.

The bottom line is, if you make your ear damp, and fill it with food these yeasts like to grow in, you will grow some kind of fungus:

Note: Atypical Lipid-Dependent Malassezia Species Isolated from Dogs with Otitis Externa

Note: Otitis Externa Associated with Malassezia sympodialis in Two Cats

Wiley InterScience :: Session Cookies

Picture of Seborrheic Otitis Externa &#160; * Otolaryngology Houston

Yeast Infections in Humans with Special Emphasis on <i>Malassezia furfur</i> and Infections Caused by 'Rare´ Yeast Species