Munson Health
 
Otitis Externa

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by McCarthy AA

(Swimmer’s Ear)

 

Risk Factors

Factors that may increase your chance of getting otitis externa include:
People with weak immune systems or who have a chronic illness, such as diabetes or AIDS , may suffer an aggressive form called malignant otitis externa. Malignant otitis externa results in infection of the cartilage and bone around the ear, as well as between the ear and the brain (the skull base). The condition can be severe and difficult to treat, causing nerve paralysis .
 

Treatment

This condition can easily be treated but can become serious, even life-threatening in some people, if left untreated. This can be very serious particularly in people with diabetes, where the infection can spread and cause malignant otitis externa.
Talk with your doctor about the best treatment plan for you. Options may include:

Medications

If you have an infection, medication will depend on the cause of the infection. Other medications will help reduce other symptoms, such as pain and inflammation. Your doctor may recommend:
  • Nonsteroidal anti-inflammatory medications (NSAIDs) taken orally to reduce pain and inflammation
  • Antibiotic ear drops to treat any infection
  • Oral antifungal medications to treat fungal infections
  • Oral antibiotics to treat severe infections or cellulitis of the ear canal
  • Corticosteroid ear drops to reduce inflammation (this may be combined with an antibiotic ear drop)
  • Intravenous antibiotics for malignant otitis externa
If the ear canal is very swollen, it may not allow the ear drops to get in. A small sponge, called a wick, may be inserted in the ear canal to absorb the drops. It is usually removed after 24-48 hours.

Drainage

If medications or ear wash do not work, your doctor may need to remove any drainage or pus from the ear canal. However, this is rarely needed.

Surgery

Malignant otitis externa requires immediate treatment, hospitalization, intravenous antibiotics, and possibly surgery. Surgery may be indicated for:
  • Infection that has spread to the base of the skull
  • Bone abscess
  • Failure of other treatment methods
Debridement, the removal of dead tissue, may also be necessary to help the healing process.

Other Suggestions

Your doctor may also recommend:
  • Keep the ear dry for 7 to 10 days
  • Take baths instead of showers
  • Avoid swimming
  • Do not rub or scratch the ear or inside the ear canal
  • Avoid using hearing aids or earplugs until you are healed
If you are diagnosed with otitis externa, follow your doctor's instructions .
 

RESOURCES

American Academy of Family Physicians
http://familydoctor.org

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org

 

CANADIAN RESOURCES

Canadian Society of Otolaryngology
http://www.csohns.com

Health Canada
http://www.hc-sc.gc.ca

 

References


Block SL. Otitis externa: providing relief while avoiding complications. J Family Practice. 2005;54(8):669-676.


National Center for Emergency Medicine Informatics. Otitis externa (swimmer's ear). National Center for Emergency Medicine Informatics website. Available at: http://www.ncemi.org/cse/cse0302.htm . Accessed November 10, 2010.


Otitis externa. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated January 7, 2013. Accessed August 29, 2013.


Rutka J. Acute otitis externa: treatment perspectives. Ear Nose Throat J. 2004;83(9 Suppl 4):20-21;discussion 21-22.


Swimmer’s ear. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/swimmersEar.cfm . Accessed August 29, 2013.


Swimmer’s ear(otitis externa). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/healthywater/swimming/rwi/illnesses/swimmers-ear.html . Updated February 15, 2013. Accessed August 29, 2013.

 

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