We did not suggest, nor do we advise that Auralgan be used in unexamined ears. As stated in our article, children with otitis externa, otorrhea, an eardrum perforation, or ventilation tube(s) in place were excluded from our study. We agree with Dr Woldman that Auralgan should not be used for otitis externa. Should a rupture of the tympanic membrane occur in children with previously diagnosed acute otitis media, pain usually is relieved, and additional Auralgan would likely not be used. In any case, the perforation is likely to be small, and pressure relationships are such that the direction of flow would be from the middle ear to the external auditory canal rather than the reverse. Neither we nor our ear, nose, and throat consultant are aware that the use of either Auralgan or olive oil eardrops has been associated with subsequent middle ear sequelae.
Hoberman A, Paradise JL. Treating Ear Pain in Children With Acute Otitis Media—Reply. Arch Pediatr Adolesc Med. 1998;152(1):102. doi: