Randomized trial of neomycin/dexamethasone spray vs drop preparation for the treatment of active chronic mucosal otitis media.

Active mucosal chronic otitis media (COM) is notoriously difficult to treat. A randomized, non-blind trial of a drop vs spray preparation of neomycin sulphate (3250 units/ml) and dexamethasone 0.1% (Otomize) has been performed. The spray was significantly better than drops (91% vs 44%) in the resolution of activity in simple perforations (P = 0.002 chi 2 test, with continuity correction). In ears with an open mastoid cavity, 68% of those on the spray preparation became inactive compared with 42% on drops, a difference which just failed to achieve statistical significance (P = 0.06). It is concluded that the spray delivery system is a significant improvement over drops for the treatment of active mucosal COM particularly in the absence of a mastoid cavity.