Otitis extern a is an acute or chronic inflammation of the skin of the external ear canal and auricle. It occurs most commonly during the summer but can occur at any time of the year.
With treatment, acute otitis externa usually subsides within 7 days; however, it may become chronic and tends to recur. Severe, chronic otitis externa may reflect underlying diabetes mellitus, hypothyroidism, or nephritis.
Other names for this disorder are external otitis and swimmer's ear.
Several things can make Otitis Externa more likely including the following:
Signs and Symptoms
A review of the patient history usually shows repeated exposure to ear trauma, water, use of earphones, or allergic response to hair spray, dye, or other hair-care products. The patient also may relate a history of mild to severe ear itching or pain (or both) that is aggravated by jaw motion, clenching the teeth, opening the mouth, or chewing.
Inspection may reveal a swollen, inflamed ear canal and an ear discharge that may be foul-smelling. In chronic otitis externa, inspection shows a thick, red epithelium in the ear canal. The patient may complain of increased pain or itching on palpation or manipulation of the pinna or tragus.
Otoscopy reveals a swollen external ear cana: (sometimes to the point of complete closure), periauricular lymphadenopathy (tender nodes in front of the tragus, behind the ear, or in the upper neck) and, occasionally, regional cellulitis.
Fungal otitis externa may be asymptomatic, although A. niger may appear on otoscopy as a black or gray, inkblotlike growth in the ear canal.
Audiometric testing may reveal a partial hearing loss. Microscopic examination or culture and sensitiviy tests can be used to identify the causative organism and determine antibiotic treatment. In fungal otitis externa, removal of the growth reveals thick, red epithelium.
Treatment - emphasizing site care and drug therapy - includes:
Surgery may be needed to excise and drain an abscess.
For the patient with a fungal infection, treatment includes:
In chronic otitis externa, treatment involves:
For mild chronic otitis externa, treatment includes:
The following steps will help you avoid otitis externa:
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