Vitamin A on tumor necrosis factor-alpha expression and otorrhea score in benign chronic suppurative otitis media

Background: Benign Chronic Suppurative Otitis Media (CSOM) is a middle ear inflammation characterized by otorrhea with perforation in the central tympanic membrane. Topical ofloxacin as a standard therapy in this type of CSOM has limitations in reducing otorrhea score. Vitamin A supplementation could be given simultaneously with topical ofloxacin because of its property as a regulator of the local immune response in the middle ear. Objectives: This study aimed to analyse the effect of vitamin A supplementation on Tumor Necrosis Factor-α (TNF-α) and otorrhea score in benign CSOM patients. Materials and Methods: The pre-experimental method with post-test only control group approach was held from January to March 2020 at Rembang Regional Hospital, Central Java, Indonesia. The subjects of the study were benign CSOM patients aged 18-60 years who did not consume antibiotics or steroids for two weeks prior to the study. Subjects of the study were divided into two groups. The standard (control) group was given topical ofloxacin as standard therapy while the intervention group was given topical ofloxacin in combination with Vitamin A supplementation. The subjects consisted of 21 subjects in the standard group and 10 subjects in the intervention group. Results: The percentage of TNF-α expression in intervention group was 64.20 ± 36.18, while the percentage in the standard group was 91.10 ± 11.3. The result of the independent t-test showed that there was a significant difference between the two groups (P = 0.016; 95% CI = 9.41-44.37). There was a significant difference in the otorrhea score between the two groups (P = 0.003). Conclusion: There was a significant difference in TNF-α expression and the otorrhea score between the standard and the intervention group.