To the Editor We read with great interest the article of Ahmed et al titled “Permanent Facial Paralysis and Hearing Loss After Aural Irrigation.”1 Their report illustrates very well how a simple aural irrigation can lead to serious consequences. We would like to discuss their case report and share a similar case from our own experience.
Regarding the case presented by Ahmed et al,1 we share the view of the authors that a superadded infection contributed to injury, and it is important to note whether a microbiologic culture of the discharge would have proven the presence of Pseudomonas aeruginosa, which can be associated with aural irrigation.2,3 In addition, we would like to know the duration of treatment with oral ciprofloxacin that the authors prescribed. For example, other authors have enacted a 2-month treatment course with 250 mg of oral ciprofloxacin.4 It is our view that, perhaps in their case, concomitant diabetes mellitus in the patient could have contributed to the pathologic findings.
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Milkov DA, Pazardzhikliev DD. The Risks of Aural Irrigation. JAMA Otolaryngol Head Neck Surg. Published online May 21, 2020. doi:10.1001/jamaoto.2020.0950
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