Otitis externa overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Otitis externa is an inflammation of the outer ear and ear canal. Along with otitis media, external otitis is one of the two human conditions commonly called "earache". It also occurs in many other species. Inflammation of the skin of the ear canal is the essence of this disorder. The inflammation can be secondary to dermatitis (eczema) only, with no microbial infection, or it can be caused by active bacterial or fungal infection. In either case, but more often with infection, the ear canal skin swells and may become painful and/or tender to touch.
Epidemiology and Demographics
The incidence of otitis externa is high. In Netherlands, it has been estimated at 12-14 per 1000 population per year, and has been shown to affect more than 1% of a sample of the population in the United Kingdom over a 12 month period.[1]
Differentiating Otitis Externa from other Diseases
Acute otitis media and acute otitis externa are easily confused because both can cause earache and drainage from the ear (otorrhea). Otitis media is the inflammation of the tympanic membrane and middle ear space and is usually clinically distinct from otitis externa. Importantly, persistent earache without the physical findings of ear infection can be due to more serious, even lifethreatening, conditions, and should always be investigated by an otolaryngologist.
Diagnosis
Laboratory Findings
Microbial culture and antibiotic sensitivity of the ear discharge may identify the bacteria or fungus causing infection.
Treatment
Medical Therapy
The goal of treatment is to cure the infection and to return the ear canal skin to a healthy condition. When external otitis is very mild, in its initial stages, simply refraining from swimming or washing hair for a few days, and keeping all implements out of the ear, usually results in cure. For this reason, external otitis is called a self-limiting condition. However, if the infection is moderate to severe, or if the climate is humid enough that the skin of the ear remains moist, spontaneous improvement may not occur.