Tea tree oil: in vitro efficacy in otitis externa

Objective: The purpose of this study was to determine the susceptibility of organisms causing otitis externa (OE) to the essential oil of Melaleuca alternifolia, or tea tree oil (TTO).

Methods: Fifty-seven swabs were taken from the ears of 52 patients with OE for culture and sensitivity. A broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of TTO for each organism.

Results: In 51 per cent of the swabs taken, pathogenic organisms were cultured. Of these cultures 71 per cent, both bacteria and yeast, were susceptible to TTO 2 per cent or less. The only organism showing resistance to TTO was Pseudomonas aeruginosa; however 25 per cent of these bacteria were sensitive.

Conclusion: Tea tree oil may have a role to play in the treatment of OE. However, more work needs to be done to enhance the anti-pseudomonal effect and to assess ototoxicity.

A novel treatment for patients with hereditary haemorrhagic telangiectasia

Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by dermal, mucosal, and visceral telangiectases as well as pulmonary and cerebral arteriovenous malformations. Recurrent epistaxis occurs in the majority of patients, and by the very nature of the thin walled vessels involved it is often refractory to conventional forms of treatment. We present the case of an 82-year-old lady with intractable epistaxis secondary to HHT, that was successfully controlled by the application of fibrin glue.