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TABLE 3

Treatments for Otalgia in AOM

Treatment ModalityComments
Acetaminophen, ibuprofen63  Effective analgesia for mild to moderate pain. Readily available. Mainstay of pain management for AOM. 
Home remedies (no controlled studies that directly address effectiveness) May have limited effectiveness. 
 Distraction  
 External application of heat or cold  
 Oil drops in external auditory canal  
Topical agents  
 Benzocaine, procaine, lidocaine65,67,70  Additional, but brief, benefit over acetaminophen in patients older than 5 y. 
 Naturopathic agents68  Comparable to amethocaine/phenazone drops in patients older than 6 y. 
Homeopathic agents71,72  No controlled studies that directly address pain. 
Narcotic analgesia with codeine or analogs Effective for moderate or severe pain. Requires prescription; risk of respiratory depression, altered mental status, gastrointestinal tract upset, and constipation. 
Tympanostomy/myringotomy73  Requires skill and entails potential risk. 
Treatment ModalityComments
Acetaminophen, ibuprofen63  Effective analgesia for mild to moderate pain. Readily available. Mainstay of pain management for AOM. 
Home remedies (no controlled studies that directly address effectiveness) May have limited effectiveness. 
 Distraction  
 External application of heat or cold  
 Oil drops in external auditory canal  
Topical agents  
 Benzocaine, procaine, lidocaine65,67,70  Additional, but brief, benefit over acetaminophen in patients older than 5 y. 
 Naturopathic agents68  Comparable to amethocaine/phenazone drops in patients older than 6 y. 
Homeopathic agents71,72  No controlled studies that directly address pain. 
Narcotic analgesia with codeine or analogs Effective for moderate or severe pain. Requires prescription; risk of respiratory depression, altered mental status, gastrointestinal tract upset, and constipation. 
Tympanostomy/myringotomy73  Requires skill and entails potential risk. 
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