Otitis externa is an infection or inflammation of the ear canal. In some cases it can extend to the pinna, tragus and ear drum. It is also referred to as swimmer’s ear.
Acute Otitis externa ear infections usually last less than 6 weeks). Chronic otitis externa lasts for more than 3 months and this is due to allergies, chronic dermatologic conditions, or inadequately treated acute otitis externa
Malignant (Necrotising) otitis externa invades the soft tissue and bones and this occurs normally in older patients with Diabetes Mellitus.
Otitis externa caused by bacteria is usually from Pseudomonas Aeruginosa and Staphylococcus Aureus. Disruption of the PH and protective factors, damage to the epithelium, loss of protective wax and accumulation of moisture leads to high PH and bacteria accumulation in the ear canal.
Infections caused by fungal pathogens are from Candida and Aspergillus, and are often in tropical environments and in patients previously treated with antibiotics.
Risk factors to be aware of
- Water in the ear canal – humidity, sweating, swimming or prolonged exposure to water
- Trauma from cerumen removal
- Use of external devices such as ear plugs, hearing aids and cotton buds
- Anatomy of the ear – narrow ear canal, hairy ear canals, exostoses (small bony growths in the ear canal)
- Dermatological conditions such as Eczema, seborrhea and Psoriasis
- Ear canal obstruction with ear wax/foreign body or sebaceous cyst
- Chemotherapy and Radiotherapy
- Stress
- Soap
- Type A blood type
- Previous radiotherapy to the head/neck
Symptoms to watch out for
- Itching in the ear
- Tenderness of tragus/pinna
- Ear pain that is worse when the pinna is pulled.
- Discharge
- Blocked sensation/ fullness in the affected ear
- Hearing loss in the affected ear
- Ear canal inflammation -oedema
- Cellulitis of the pinna
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