To compare the therapeutic efficacy in the management of granular myringitis, 15 patients with chronic granular myringitis were treated with antibiotic ear drops that were used twice to four times a day, and another 15 patients were treated with daily irrigation of the external canal with dilute vinegar solution. All patients treated with dilute vinegar solution had resolution of their original otorrhoea within three weeks, whereas two-thirds of patients recovered within three weeks when treated with antibiotic ear drops. The disadvantages of dilute vinegar therapy were canal irritation with pain and dizziness. When the therapeutic efficacy was compared statistically, a dry ear was attained in the dilute vinegar-treated group at six weeks and six months in the antibiotic ear drop treated group (p<0.01). These results suggest that very low pH therapy using dilute vinegar solution is definitely effective in the management of granular myringitis.