This topic provides information about otitis externa.
What is otitis externa?
Otitis externa, or more commonly known Swimmer’s Ear, is an inflammation or infection of the outer ear or external auditory canal (ear canal).
It is most commonly a baterial infection but can also be a fungal infection. Otitis externa is classified as either acute or chronic. Acute otitis externa (OE) occurs rapidly (usually within 48 hours) and resolves quickly with treatment. Chronic otitis externa (OE) is the same as acute OE but lasts longer than 6 weeks or occurs more than 4 times a year.
OE can occur at any age and affects both genders equally.
What Causes otitis externa?
Otitis externa has 4 main causes.
- Excessive exposure to moisture in the ear canal, such as with swimmers
- Use of a foreign body in the ear canal, such as Q-tips or hearing aids
- Allergies or skin conditions, such as eczema
- Exposure to humid or tropical climates
You have a greater chance of getting otitis externa if you are a swimmer or if you live in a humid climate. This is because excessive exposure to water in the ear canal can make it more susceptible to infection.
You also have a greater chance of getting otitis externa if you use Q-tips in the ear canal. This can dry out the skin of the ear canal and cause cuts or sores which can lead to infection.
What are the symptoms?
Symptoms of otitis externa can include:
- Pain in the ear (otalgia)
- Fullness of the ear
- Itchy ear
- Temporary hearing loss
- Drainage from the ear (otorrhea)
- Facial swelling and jaw pain can occur in severe cases
How is otitis externa diagnosed?
Otitis externa can be easily diagnosed by a physician looking in the ear with an ototscope (otoscopy). The ear canal may appear red or swollen. There may also be the presence of flaky skin or eczema-like condition, debris or drainage in the ear canal.
Although not a part of the routine diagnosis of OE, a culture can be taken to determine the bacteria or fungus causing the infection.
How is it treated?
Otitis externa is a treatable condition that usually resolved quickly.
Otitis externa is most commonly treated with use of ear drops containing antibiotic or antibiotics with corticosteroids to reduce inflammation. Oral antibiotics may be used in some cases.
Before drops are used, the physician will suction, or clean out, the ear canal to remove any debris and decrease infectious material.
During treatment of OE, it is crucial to keep the ear canal dry. When showering, the use of an ear plug is recommended.
Does otitis externa cause lasting problems?
If left untreated, the otitis externa infection can spread to the bone and underlying structures around the ear progressing to necrotizing otitis externa. This is more common in elderly immunocompromised individuals such as those with diabetes, AIDS or undergoing chemotherapy. This can result in severe pain even after treatment has cleared the visible infection. Mortality can occur in extreme cases.