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In vitro investigation of ceruminolytic activity of various

otic cleansers for veterinary use


Blackwell Publishing Ltd

J. Snchez-Leal*, I. Mays, J. Homedes and


L. Ferrer
*Departamento de Tecnologa de Tensioactivos, IIQAB-Consejo
Superior de Investigaciones Cientficas (CSIC), Barcelona, Spain
Veterinaria Esteve, Laboratorios Dr Esteve S.A. Barcelona, Spain
Departament de Medicina i Cirurgia Animals, Universitat Autnoma
de Barcelona, Spain
Correspondence: Josep Homedes, Veterinaria Esteve, Laboratorios
Dr Esteve S.A. Barcelona, Spain. E-mail: jhomedes@esteve.es
This study was partially presented at the 19th Annual Congress of the
European Society of Veterinary DermatologyEuropean College of
Veterinary Dermatology (ESVD-ECVD) (Tenerife, Spain. September
2003).
This study was kindly sponsored by Laboratorios Dr Esteve S.A.

Abstract
Knowledge of the ceruminolytic activity of commercially available ear cleansing products assists the practitioner to choose the best available product for
specific clinical situations. The aim of this study was
to quantify and compare the ceruminolytic activity of
commercially available canine ear cleansers. For this
purpose, the ceruminolytic activity of 13 ear cleansers
was evaluated using a standardized synthetic cerumen (SSC) that mimics the composition and texture of
canine cerumen. The test products were incubated
with mild agitation for 20 min with 500 mg of SSC previously compacted at the bottom of a test tube. Ceruminolytic activity was then assessed by quantifying
the SSC removed by decantation. This procedure was
repeated five consecutive times on each tube simulating repeated applications in the canine ear canal. Good
repeatability among replicates was found in this
assay, allowing direct comparisons between products. The final percentage of SSC elimination ranged
from none (similar to water), between 8 and 39% for
three products and up to 90% for one product
(P < 0.001). It is concluded that, in the experimental
conditions used in this study, only 1/13 products had
significant ceruminolytic activity.
Received 21 July 2005; accepted 21 December 2005

Introduction
Canine ear canals are rich in sebaceous and ceruminous
glands which produce the lipids contained in cerumen.1
Cerumen is a complex mixture of exfoliated cells, waxes,
oils, free fatty acids, esters, immunoglobins and proteins,
which act as an antimicrobial and protective barrier for the
ear canal.1,2 Debris entering the ear canal are trapped and

removed naturally with the cerumen.2 However, an excess


of cerumen may be irritating, prevent medications from
contact with the ear canal wall and create a favourable
environment for microorganisms to proliferate.3 Accumulation of cerumen in the external ear canal predisposes to
otitis externa in dogs and enhances the growth of the
yeast Malassezia pachydermatis, an organism frequently
found resident on the canine aural integument.1 Ear cleaning can be beneficial in maintaining the normal otic environment, especially in seborrhoeic or allergic dogs with
excessive cerumen in their ears.2 Cleansing is also necessary in order to adequately explore the internal structures
of the ear like the external meatus and tympanum, and it
is important in the treatment of otitis.4,5
A wide range of ear cleansing preparations and procedures aimed to remove exudates and ceruminous debris
have become very popular in veterinary practice.2 Among
other components, most of the commercially available
products for routine cleansing contain ceruminolytics.
Ceruminolytic agents include organic oils, solvents (e.g.
propylene glycol, lanolin, glycerine, squalene, butylated
hydroxytoluene, cocamidopropyl betaine and mineral oils),
surfactants (e.g. dioctyl sodium sulfosuccinate, calcium
sulfosuccinate) to soften and dissolve cerumen, and
astringents or drying agents (e.g. isopropyl alcohol, boric
acid, benzoic acid, salicylic acid, sulphur, aluminium acetate,
silicon dioxide, acetic acid) to dry the ear canal and prevent
maceration.2,3 These components are often formulated in
an oily base and are often classified as ceruminolytics,
drying agents or cleansers.6,7 Some of the ingredients may
have additional antibacterial/antifungal effects.8,9
Although some clinical approaches have been made to
evaluate their cleansing activity8,10 or their safety,5 comparative in vivo trials with ear cleansers are very difficult.
Some of the limitations of these studies include the need
for long-term treatments and follow-ups, wide variability in
baseline scores and the expense of multicentre trials
following a strict protocol. For this reasons, very few in vivo
or in vitro studies of ceruminolytic activity of veterinary ear
cleaning products have been conducted.11,12 The objective
of this study was to compare the ceruminolytic activity of 13
commercially available veterinary ear cleansers. Because
an in vivo study to test several products simultaneously
would have been unaffordable, an in vitro method was
developed to provide an objective and comparable measure
of the ceruminolytic activity. The study design used was based
on previously developed in vitro tests in humans.1315

Materials and methods


Testing protocol
A standardized synthetic cerumen (SSC) mimicking the lipidic
composition and texture of canine cerumen was prepared to ensure

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121

J Snchez-Leal et al.

Table 1. Composition of the standardized synthetic cerumen (SSC)


Myristic acid (ref: M-3128, Sigma-Aldrich)
Palmitic acid (ref: P-0625, Sigma-Aldrich)
Oleic acid (ref: 75096, Fluka Riedel-deHan)
Cholesterol (ref: C-8503, Sigma-Aldrich)
Squalene (ref: S-3626, Sigma-Aldrich)

33.6%
33.6%
9.4%
10.9%
12.5%

sufficient quantities and homogeneity of the material. The composition of this cerumen was based on the average composition of
natural canine cerumen as described in the literature,1,1618 although
concentration of oleic acid was slightly lowered in order to obtain
adequate consistency and malleability. Final composition of SSC is
described in Table 1. Briefly, each component of SSC was carefully
weighed. Solid ingredients (cholesterol, myristic acid and palmitic
acid) were placed in a beaker and blended with a spatula. Then, liquid
ingredients (squalene and oleic acid) were slowly added and thoroughly
mixed until a homogeneous mass was obtained.
In order to assess chemical similarity between SSC and natural
cerumen, canine and human cerumen samples, olive oil, and SSC
were dissolved in chloroform : methanol (2:1) and applied to thin layer
chromatography (TLC) plates. Normal canine cerumen was obtained
from a healthy beagle colony (Isoquimen SL, Spain). Human cerumen
was a pool of samples generously provided by Consejo Superior de
Investigaciones Cientficas (CSIC). Olive oil was included as a reference for its high content in triglycerides. Plates were developed with
an hexane : diethyl ether : acetic acid mixture (80:20:1) and air dried
in a fume cupboard. Spots corresponding to every chemical component of the samples were visualized after spraying the plates with
perchloric acid (40%) and heated at 180 C. Individual components
were identified using in parallel standard solutions of each one. Good
correspondence in the retardation factor (Rf) values of the most
important lipidic fractions was found (Fig. 1).
Aliquots of approximately 500 mg of the SCC mass were rolled and
placed into individual 3 mL polypropylene test tubes (Nirco SA, Spain.
Ref: 17-5594D). The size of the tubes (11 75 mm) was chosen to
simulate the conditions of a dog ear canal. It was estimated that
500 mg of SSC was the maximum amount of cerumen that would still
leave enough tube space for the tested products. The tubes were
placed in a vertical position in a test tube rack and heated at 41 C for
5 min in order for the melted cerumen to homogeneously slide and
to compact to the bottom of the tube thus resembling the conditions
in which cerumen is found in the dog ear canal.
Once cold and solidified, the tubes were carefully weighed and
filled with 2 mL of the test product. This amount was chosen because
it allows good interaction with the SSC plug while is compatible with
the size of the tubes used and with the recommended ear cleansing
practice. Filled tubes were then incubated in a shaker at 35 C for
20 min with mild agitation at 130 cycles/min (Denmark Comfort
Heto Master Shake, Heto-Holten A /S, France. Type: SBD50-1), thus
resembling the temperature,19,20 contact time4 and head shaking4
that would occur in a real ear. Tubes were then inverted for 1 h, allowing
enough time for the dispersed SSC and the test product mixture to
slide out of the tube. Finally, all tubes were weighed again to calculate
the exact amount of remaining SSC. This procedure was repeated five
times on each tube simulating consecutive applications of the products
until complete removal of the SSC plug in the positive control was
achieved (tests 15).
Initial and final weights of the tubes in each test were used to calculate the percentage of SSC removed. Individual results of each replicate were used to calculate the average percentage of removed SSC.

Figure 1. Thin layer chromatography (TLC) showing the composition


of natural canine cerumen (1) vs. standardized synthetic cerumen
(SSC) (4). Samples of human cerumen (3) and olive oil (2) are also
shown for comparative purposes. Individual components were
identified using parallel standard solutions of each one (not shown)
and measuring the distance traveled from the spotting line (origin) to
the centre of each spot relative to the distance the solvent traveled
(retardation factor).

(Cerumene, Schering-Plough Animal Health, Spain), EP (Epiotic,


Virbac SA, Spain), SP (Specicare, Lovens Animal Health Division
Farmacus SA, Spain)] and compared with distilled water as negative
control (A). All replicates were tested simultaneously. Based on the
results of phase I, OT was chosen as a reference of high activity and
water (A) as negative control for further trials. In phase II, five new
products were tested again following the same procedure as in phase
I [VET (VET Ear cleansing solution, Vet Solutions, Canada), ROU
(Routeen, BIMEDA-MTC, Canada), CLO (Clorexyderm, ICF, Italy), O-LA
(Otolane, Laboratoires TVM, France), AUR (Aurinet, Keva Laboratory
NV, Belgium)]. In phase III four additional ear cleansers [O-FR (Otifree, Vetoquinol, France), NET (Netaural, Boehringer Ingelheim SA,
Belgium), OOR (Oorreiniger, AST Farma, the Netherlands), DETE
(Dtcane, Janssen-Cilag, France)] were tested. In each phase, all
replicates were run simultaneously by an investigator blinded to treatment group.

Products tested
The products tested were samples of the most representative commercially available products in several countries. All products were
freshly obtained from authorized distributors of Belgium, Canada,
France, Italy and Spain, and were used well in advance of their expiry
date. Details of each product are described in Table 2.
The trial was run in three phases. In phase I, four products were
chosen [OT (Otoclean, Laboratorios Dr Esteve SA, Spain), CE

122

Statistics
Percentages of SSC removed by all products in each test were statistically analysed by analysis of variance (ANOVA) to detect the existence
of any significant difference, whereas Tukey pairwise comparisons test
was used to isolate the differences among treatments within each
test. A level of significance of P < 0.05 was selected. SIGMA STAT version
2.0 Copyright 199295 Jandel Corporation was used for the analyses.

2006 The Authors. Journal compilation 2006 European Society of Veterinary Dermatology.

Ceruminolytic activity of otic cleansers

Table 2. Declared composition of the products tested


Product

Declared composition

Details

AUR

Squalene (21%), allantoin (0.25%), almond oil (37%)

CE

Squalene (25%), isopropyl miristate, liquid parafine

CLO

Propylene glycol (10%), lactic acid (2.5%),


salicylic acid (0.1%), chlorhexidine (0.05%)
Pistocaine (0.2%), benzalkonium chloride (0.025%), excipient

Aurinet, Keva Laboratory NV, Belgium.


Batch Number 032001
Cerumene, Schering-Plough Animal Health, Spain.
Batch Num.3712
Clorexyderm, ICF, Italy. Batch Number 0040

DETE
EP
NET

O-FR
O-LA
OOR
OT
ROU
SP

VET

Salicylic acid (0.11%), lactic acid (2.98%), docusate sodium (0.388%),


propylenglycol (33.5%), microcapsules (9%), water
Menthol (0.91%), chlorothymol (0.1%), sodium tetraborate
pentahydrate (borax) (0.4%),
sodium lauryl sulphate (0.08%), isopropyl alcohol, propylene glycol, water
Propylene glycol, plant extracts (Calendula), surfactant, water
Chlorhexidine digluconate (0.2%), acetic acid (0.5%),
neutral cleanser base-hydrating agents
Salicylic acid (0.1%), lactic acid (2.5%), chlorhexidine acetat (0.2%),
sodium lauryl sulphate, propylene glycol
Salicylic acid (0.23%), lactic acid, oleic acid, propylene glycol,
ethoxydiglycol, glycerine, plant extracts, water
Malic acid (1%), salicylic acid (0.15%), propylene glycol,
neutral salicylic esters, neutral benzoic esters, benzoic acid
Menthol (0.9%), chlorothymol (0.1%), sodium tetraborate
pentahydrate (borax) (0.4%), sodium lauryl sulphate (0.074%),
isopropyl alcohol, propylene glycol, water
SD-alcohol (10%), lactic acid (1.76%), dioctyl sodium
sulfosuccinate (1.1%), benzoic acid (0.15%), salicylic acid (0.1%)

Figure 2. Appearance of a selection of the tubes after three consecutive assays in phase I showing different degrees of standardized synthetic cerumen (SSC) disintegration. As described in Table 1, after test
3, water (A) and Epiotic (EP) did not show any effect on the SSC plug,
whereas Cerumene (CE), Specicare (SP) and Otoclean (OT) induced
an increasing degree of SSC disintegration and removal.

Results
Figure 2 shows the appearance of the test tubes in several
stages of the plug breakage. A small quantity of the test
products remained inside the tubes even when all of the
SSC was apparently removed; therefore 100% efficacy
could never be achieved. Results of phases I, II and III are
shown in Tables 3, 4 and 5 and represented in Figs 3, 4
and 5, respectively. The negative values indicate impregnation of the product in the SSC without its disintegration
and elimination.
In phase I, the final percentage of SSC elimination was
almost complete for OT (86.5%) and was significantly
greater than SP (23.4%) and CE (8.4%) (P < 0.001). These

Dtcane, Janssen-Cilag, France.


Batch Number 03EQ038
Epiotic, Virbac SA, Spain.
Batch Number 0B1B
Netaural, Boehringer Ingelheim SA, Belgium.
Batch Number 509302
Otifree, Vetoquinol, France. Batch Number DG01A
Otolane, Laboratoires TVM, France. Batch
Number M0106B
Oorreiniger, AST Farma, the Netherlands.
Batch Number 03I093
Otoclean, Laboratorios Dr Esteve SA, Spain.
Batch Number V01
Routeen, BIMEDA-MTC, Canada. Batch Number 3E302
Specicare, Lovens Animal Health Division
Farmacus SA, Spain.
Batch Number 308172
VET (ear clean sing solution), Vet Solutions, Canada.
Batch Number 03013

differences were already significant after test 2 and became


even greater after every consecutive run. On the other
hand, EP showed a behaviour similar to that obtained with
the negative control, with no evident ceruminolytic activity. These results showed that the procedure was able to
objectively discriminate different products for their in vitro
ceruminolytic activity. Based on these results, OT was
included as a reference of high activity in other phases.
In phases II and III, the rate and extent of ceruminolytic
activity of OT and A (taken as references of high and low
activity) were similar to those of phase I (see Figs 3, 4 and 5).
Again, OT was more efficacious than the other products, reaching a ceruminolytic activity of 90%, whereas all
other products showed much lower or even negative
values (P < 0.001). In phase II, all tested products except
OT behaved similarly to distilled water. Although some
statistical differences were detected among these products at several runs, all values were negative, meaning
that part of the test product remained in the tube, but without any detectable action on the cerumen plug (Table 4).
Similar results were found for phase III in which only OT
and NET had significant ceruminolytic activity (89.6 and
39.1%, respectively) with OT having significantly greater
ceruminolytic activity than NET, starting with test 2
(P = 0.008).
Overall, OT was most efficacious, reaching an activity of
8690% followed by NET with a 39%, SP with a 23% and
CE with an 8% ceruminolytic activity. None of the other
products displayed any ceruminolytic activity.

Discussion
In this study, only four products were able to remove all or
part of the SSC plug. The other nine products performed

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J Snchez-Leal et al.

Table 3. Percentage of standardized synthetic cerumen (SSC) removed after each run in phase I. Mean standard deviation (n = 7)
Sample

Test 1

Test 2

A
OT
CE
EP
SP

2.6 0.8
5.1 2.3b,c
2.6 1.1a,c
3.5 0.5a
8.0 1.9c
a

Test 3

3.7 0.8
26.7 5.6b
5.1 1.9c,d
5.7 0.6a
11.0 1.3c
a

Test 4

3.6 0.6
64.6 18.2b
7.7 3.1c
6.2 0.8a
15.8 1.5d
a

Test 5

2.9 0.8
81.9 2.5b
7.8 2.1c
5.5 0.3a
24.1 2.2d

5.3 1.1a
86.5 2.3b
8.4 2.4c
8.1 0.4a
23.4 2.8d

Superscripts with different letter in the same column mean that the products showed statistical differences (P < 0.01) in Tukey pairwise
comparisons test. Negative values indicate that there has been only impregnation of the product in the SSC, but its disintegration and elimination
were not achieved. n = number of replicates; A = water; OT = Otoclean; CE = Cerumene; EP = Epiotic; SP = Specicare.

Table 4. Percentage of standardized synthetic cerumen (SSC) removed after each run in phase II. Mean standard deviation (n = 8)
Sample

Test 1

Test 2

A
OT
VET
ROU
CLO
O-LA
AUR

0.5 0.3
11.7 3.7b
1.5 0.9a
3.6 0.7a
1.4 0.5a
3.8 0.5a
6.5 1.5a
a

Test 3

0.6 0.1
34.5 5.6b
0.1 1.2a
0.2 0.6a
0.2 0.8a
1.6 0.8a
7.9 1.8c
a

Test 4

1.4 0.4
79.0 12.2b
0.7 1.3a
2.4 1.7a
1.6 0.5a
4.5 1.1a
4.5 5.6a
a

Test 5

1.5 0.3
89.4 2.4b
1.1 1.4a,c
3.0 0.9a,c,d
3.0 0.9a,c,d
5.9 1.5a,d
6.5 1.7a,d
a

1.8 0.4a
90.0 2.4b
2.0 2.0a,c
5.6 2.0a
3.3 1.0a,c
9.2 1.6c
6.2 1.5a

Superscripts with different letter in the same column mean that the products showed statistical differences (P < 0.01) in Tukey pairwise
comparisons test. Negative values indicate that there has been only impregnation of the product in the SSC, but its disintegration and elimination
were not achieved. n = number of replicates; A = water; OT = Otoclean; VET = VET (ear cleansing solution), ROU = Routeen, CLO = Clorexyderm,
O-LA = Otolane, AUR = Aurinet.

Table 5. Percentage of standardized synthetic cerumen (SSC) removed after each run in phase III. Mean standard deviation (n = 5)
Sample

Test 1

Test 2

Test 3

Test 4

Test 5

A
OT
O-FR
NET
OOR
DETE

0.8 0.2a
12.2 3.0b
0.8 0.6a
14.1 3.4b
2.7 0.6a
0.7 0.7a

0.6 0.2a
23.1 4.0b
1.4 1.1a
16.9 4.3c
2.0 2.0a
1.4 0.5a

0.7 0.2a
51.2 9.1b
1.2 0.8a
22.7 3.2c
2.2 2.8a
0.3 0.6a

1.2 0.7a
85.0 4.1b
2.4 1.1a
27.9 4.7c
5.5 3.2a
4.6 2.2a

0.9 0.2a
89.6 3.5b
0.7 1.4a
39.1 4.5c
2.1 2.6a
0.7 1.1a

Superscripts with different letter in the same column mean that the products showed statistical differences (P < 0.01) in Tukey pairwise
comparisons test. Negative values indicate that there has been only impregnation of the product in the SSC, but its disintegration and elimination
were not achieved. n = number of replicates; A = water; OT = Otoclean; O-FR = Otifree, NET = Netaural, OOR = Oorreiniger, DETE = Dtcane.

Figure 3. Graphic representation of the percentages of SSC removed


from the test tubes after each of five consecutive applications of the
tested products in phase I (mean SD). Negative values indicate that
there has been only impregnation of the product in the SSC, but its
disintegration and elimination was not achieved. See Table 3 for
statistical differences. SSC = standardized synthetic cerumen;
A = water; OT = Otoclean; CE = Cerumene; EP = Epiotic;
SP = Specicare.

124

Figure 4. Graphic representation of the results of the phase II (mean


SD) See Table 4 for statistical differences. SSC = standardized
synthetic cerumen; A = water; OT = Otoclean; VET = VET
(ear cleansing solution), ROU = Routeen, CLO = Clorexyderm,
O-LA = Otolane, AUR = Aurinet.

2006 The Authors. Journal compilation 2006 European Society of Veterinary Dermatology.

Ceruminolytic activity of otic cleansers

Figure 5. Graphic representation of the results of phase III


(mean SD). See Table 5 for statistical differences.
SSC = standardized synthetic cerumen; A = Water;
OT = Otoclean; O-FR = Otifree, NET = Netaural,
OOR = Oorreiniger, DETE = Dtcane.

no differently from water and only had the effect of a moistening agent. OT was fastest and most effective at breaking up the SSC plug. In all three phases, its effects were
already noticeable and statistically different from water in
the first test and confirmed from then on. OT was able to
break up the entire SSC plug, even thought it did not
achieve 100% efficiency as some product and cerumen
residues remained stuck to the test tube wall and were
not detached by simple gravity.
The ceruminolytic activity of NET, SP and CE was visible
and statistically different from water in the first or second
test and gradually increased in the following extractions,
reaching percentages of 39%, 23% and 8%, respectively.
As in the case of OT, these percentages are probably
lower than the total cerumen removed because some
may be left on the tube wall. As an increasing amount was
removed in each test, it is probable that with more extractions they would have finally achieved complete plug
dispersion as OT. Five consecutive tests were insufficient
to observe any cerumen dispersing effect with EP, O-LA,
AUR, VET, ROU, CLO, O-FR, OOR, DETE or water (A).
The assay showed good repeatability among replicates
with relatively small standard deviations. OT and water,
both tested in all the phases, produced results that were
practically identical throughout. These results confirm that
the method is suitable for direct, objective comparisons
between the products.
Dispersing the lipidic fraction of cerumen facilitates
cleaning of the ear canal.4,6 Authors such as Nielloud
et al.12 have therefore studied the effect of canine ear
cleansers in the dissolution of a synthetic cerumen. These
authors quantified the effect of the cleansers after passing
the mixture of cleanser and cerumen through a 10-m
filter. This method is dissimilar to natural conditions, as it
measures only dissolved earwax, the most extreme way
in which earwax can be removed. In the natural cleansing
process in the canine ear canal, the cleanser would first
impregnate and disaggregate the earwax, thus facilitating its flushing out of the ear canal without necessarily
dissolving the lipids completely. The cerumen used by
Nielloud et al.12 did not include ingredients known to
be constant constituents of canine cerumen such as

cholesterol.1 Instead, they used paraffin and lanolin, neither


of which has been described in animal cerumen.1,1618 This
could influence the performance of the products tested.
In the present study, an improved cerumen composition
without filtering allowed larger particles to be flushed
away as a consequence of either breakage or dissolution
of the SSC, resembling natural conditions more closely.
Even with the difference in methodology, the results
obtained from this study are comparable with those of
Nielloud et al.12 in which OT exhibited significant ceruminolytic activity compared to water and there was no significant difference between the ceruminolytic activity of
water and O-LA.
A limitation of these in vitro assays is that only the lipolytic effect of the products was evaluated assuming that
breaking the lipidic plug is the basic mechanism to achieve
adequate cleansing of ceruminous ears. Possibly, closer
to in vivo results could be obtained by adding other components to the SSC, such as keratin or other proteins
normally found in natural cerumen. However, nonlipidic
components may increase test variability unnecessarily as
the precise nature and proportions of these components
have not been described. Further investigations would be
necessary.
Nevertheless, the objective of this trial was to objectively
compare the ceruminolytic activity of different ear cleansers
rather than giving an absolute efficacy value for each of them.
The method enables screening and easy comparison of
the performance of many products in a standardized
fashion, thus avoiding the huge variability and difficulties
involved in obtaining this information through in vivo trials.
In order to obtain absolute efficacy values, adequately
designed field trials should be performed with each
product.

Conclusions
Given the high degree of complexity in the formulation of
most commercially available ear cleansers and the limited
information available on their labelling, particularly on its
detailed composition, it is difficult for the practitioner to
have reliable data of their ceruminolytic properties. Moreover, the results obtained in this study indicate that the
ceruminolytic capabilities of the products available on
the market are not easily deduced by their stated composition. Also, notwithstanding the action of their principle
components, the combined action of the complete formulation has to be considered and this information is normally
not in the public domain. The present study was not
designed to elucidate the effects of each of the different
components included in these products; however, the
methods described in this study could be a useful guide
for further research in this field. For the veterinary practitioner, the results of the present trial give objective data on
the comparative ceruminolytic effectiveness of the most
common ear cleansing products on the market. This can
be useful to choose by ceruminolytic capability, the most
appropriate product for each clinical situation. Although
the values obtained apply only to the experimental conditions used in this trial, these results suggest that OT
would be the most effective and rapid ceruminolytic of the
products tested.

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Rsum La connaissance de laction crumenolytique des nettoyants auriculaires aide le clinicien choisir
le meilleur produit en fonction de la situation clinique. Le but de cette tude tait de quantifier et de comparer
laction crumenolytique de produits commercialiss. Dans ce but, lactivit crumenolytique de 13
nettoyants a t value en utilisant un crumen synthtique (SSC) qui imite la composition et la texture
du crumen du chien. Les produits tests ont t incubs avec une agitation modre pendant 20 minutes
avec 500 mg de SSC pralablement compact la base dun tube essai. Lactivit crumenolytique a t
dtermines en quantifiant la quantit de SCC limine aprs dcantation. Cette procdure a t rpte
5 fois conscutivement dans chaque tube, imitant des applications rptes dans le conduit auditif externe.
Une bonne rptabilit a t observe, permettant une comparaison des produits tests. Le pourcentage
final dlimination du SCC variait de nul (similaire de leau), entre 8 et 39% pour 3 produits, et jusqu 90%
pour un produit (P < 0.001). Il est conclu que dans les conditions exprimentales de cet essai, seul 1/13
produit prsente une activit crumenolytique significative.
Resumen El conocimiento de la actividad cerumenoltica de soluciones de limpieza comerciales ticas
ayuda al clnico a escoger el mejor producto disponible para diferentes situaciones clnicas. El propsito de
este estudio fue cuantificar y comparar la actividad cerumenoltica de varios productos ticos de limpieza
para perros. Con este objetivo, 13 productos limpiadores fueron evaluados utilizando un cerumen sinttico
modelo que mimetiza la composicin y textura del cerumen canino. Los productos probados fueron incubados
con ligera agitacin durante 20 minutos con 500 mg del cerumen sinttico previamente compactado en el
fondo de un tubo de ensayo. La actividad cerumenoltica se evalu mediante la cuantificacin del cerumen
sinttico removido mediante decantacin. Este procedimiento fue repetido en cinco ocasiones en cada tubo,
simulando as aplicaciones repetidas en el odo canino. Se encontr bastante consistencia en las repeticiones, lo que permiti una comparacin entre los diferentes productos. El porcentaje final de cerumen
sinttico eliminado vario entre 0 (similar a agua), de 839% para tres productos, y hasta un 90% para un
producto (P < 0.001). Concluimos que bajo estas condiciones experimentales, solo uno de 13 productos
present actividad cerumenoltica suficiente.
Zusammenfassung Das Wissen ber die cerumenolytische Aktivitt von kommerziell erwerblichen
Ohrreinigungsprodukten hilft dem Praktiker das bestmgliche Produkt fr spezielle klinische Situationen zu
whlen. Das Ziel dieser Studie war es, die cerumenolytische Aktivitt von kommerziell erwerblichen
Ohrreinigern fr Hunde quantitativ zu bestimmen und zu vergleichen. Zu diesem Zweck wurde die cerumenolytische Aktivitt von 13 Ohrreinigern an einem standardisierten synthetischen Cerumen (SSC),

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Ceruminolytic activity of otic cleansers

welches in Zusammensetzung und Textur dem Hundecerumen gleicht, evaluiert. Die zu testenden Produkte
wurden bei leichter Bewegung fr 20 Minuten mit 500mg SCC inkubiert, welches davor am Boden des
Reagenzrhrchens zusammengepresst worden war. Die cerumenolytische Aktivitt wurde dann beurteilt,
indem die durch Dekantieren entfernte Menge an SCC bestimmt wurde. Diese Vorgangsweise wurde
fnfmal hintereinander bei jedem Reagenzrhrchen wiederholt, um die wiederholte Applikation in den
Ohrkanal zu simulieren. Bei diesem Test wurde eine gute Reproduzierbarkeit zwischen den Replikaten
gefunden, was einen direkten Vergleich der Produkte erlaubte. Der Restprozentsatz fr die Eliminierung von
SCC erstreckte sich von 0 (hnlich wie Wasser), zwischen 8 und 39% fr drei Produkte und bis zu 90% fr
ein Produkt (P < 0.001). Es wird daraus geschlossen, dass unter den experimentellen Bedingungen, wie
sie in dieser Studie verwendet worden waren, nur 1/13 Produkten eine signifikante cerumenolytische
Aktivitt aufwies.

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