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Acute otitis externa

24-11-2019,
dr. Paulina Raczyńska

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Acute otitis externa

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Acute otitis externa is a diffuse inflammatory process within the external auditory canal, sometimes involving the eardrum and auricle. It is more common in swimmers and people living in warm climates with increased humidity. The disease is sometimes attributed to genetics - a predisposition to this type of infection in people with blood type A.

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The cause of acute otitis externa is multifactorial. It is favoured by exposure to water, aggressive cleaning of the ears that causes local trauma, wearing hearing aids, regular and excessive toileting of the ears and excessive use of ear drops that damage the natural protective barrier. This ailment is caused in the vast majority of cases by bacteria(Pseudomonas aeruginosa and Staphylococcus aureus). It is extremely rare for symptoms to be caused by a fungal infection (usually following topical antibiotic treatment).

Very characteristic symptoms of acute otitis externa include a sharp pain in the ear radiating towards the jaw and a stinging and fullness sensation with concomitant hearing loss and dizziness. On physical examination, tenderness on pressure on the sclera or auricle, swelling of the ear canal and redness of the ear canal are also observed.

Topical antibiotics are most effective in the treatment of acute otitis externa. Sometimes, in cases of severe infection, a systemic antibiotic is used in addition. Patients who have received appropriate medication are advised to:

  • drying the ear thoroughly before applying the medication,
  • application of topical medication by a second person,
  • remaining in a supine position 3-5 minutes after application to allow proper penetration of the drug,
  • moving the auricle gently to distribute the medication accurately,
  • avoiding cleaning the ears as the infection makes them very sensitive,
  • not removing the tampon before being so instructed by the doctor.

Acute otitis externa is quite common. If the above symptoms occur, it is advisable to see a specialist, as complications can arise if the symptoms present are neglected.