Otitis Externa - Causes, Symptoms and Treatment

Otitis externa is commonly known as swimmer's ear. Otitis externa is an inflammation of the outer ear and ear canal and caused by many different types of bacteria or fungi. Most ear canal infections are caused by excessive moisture carrying bacteria. Another common cause is local trauma allowing bacteria to enter compromised skin. The most common causative organism is Pseudomonas species. Staphylococci, streptococci, and (in rare cases) fungi are other causative agents. Otitis externa occurs in 4 of every 1000 people each year in the US. The condition is most common in persons who are swimmers and/or divers or who have other exposures that allow contaminated water to be trapped in the external canal. Once the ear canal is blocked, hearing will be dampened (conductive hearing impairment ) until the condition improves. In very severe cases, the skin infection can spread to the face (facial cellulitis ) and to the major salivary gland in the cheek ( parotitis ). In that situation, moving the jaw and eating become painful. In its mildest forms, external otitis is so common that some ear nose and throat physicians have suggested that most people will have an episode at some point in life. In many individuals, for the reasons discussed below, the condition is recurrent and will happen several times in a lifetime. A folliculitis of one of the hairs of the outer portion of the ear canal can be the start of a bout of external otitis. The primary symptom of otitis externa is ear pain, which can be severe and gets worse when the earlobe or other exterior part of the ear is pulled or pressed on. Sometimes the ear canal itches before the pain begins. Swelling is common in typical cases of otitis externa.

Swimming in polluted water is a common way to contract swimmer's ear. Purulent otitis media with perforation of the tympanic membrane and drainage. Cleaning your ears can remove the protective wax layer and lead to infection. The two factors that are required for external otitis to develop are (1) the presence of germs that can infect the skin and (2) impairments in the integrity of the skin of the ear canal that allow infection to occur. If the skin is healthy and uninjured, only exposure to a high concentration of pathogens, such as submersion in a pond contaminated by sewage , is likely to set off an episode. However, if there are chronic skin conditions that affect the ear canal skin, such as atopic dermatitis , seborrheic dermatitis , psoriasis or abnormalities of keratin production, or if there has been a break in the skin from trauma, even the normal bacteria found in the ear canal may cause infection and full-blown symptoms of external otitis. The bacterial pathogens at the top of the list are Pseudomonas aeruginosa and Staphylococcus aureus , followed by a great number of other gram-positive and gram-negative species. Candida albicans and Aspergillus species are the most common fungal pathogens responsible for the condition. Most OE infections can be treated with ear drops, but sometimes pills are needed. Effective medications include ear drops or sprays containing antibiotics to fight infection, and corticosteroids to reduce itching and inflammation. Ear drops used abundantly help in clearing out the shed skin and dead bacteria in the ear canal, as well as in directly fighting the infection by interfering with the growth of bacteria. , pills may be used in addition to the topical medications. Analgesics may be used if pain is severe. Putting something warm against the ears may reduce pain.

Causes of Otitis Externa

Common Causes and Risk factors of Otitis Externa

• Traumatized external canal (particularly due to cotton-tipped swabs).
• Bacterial infection (Pseudomonas species and Staphylococcus species ).
• Fungal infection-Aspergillus species.
• Yeast -Candida species.
• Eczematous otitis externa.
• Seborrhea.
• Neurodermatitis.
• Swimming.

Sign and Symptoms of Otitis Externa

Common Sign and Symptoms of Otitis Externa

• Itch.
• Swelling.
• Pain.
• Hearing loss.
• Redness.

Treatment for Otitis Externa

Common Treatment for Otitis Externa

• Most OE infections can be treated with ear drops.
• Effective medications include ear drops or sprays containing antibiotics to fight infection, and corticosteroids to reduce itching and inflammation. Ear drops used abundantly help in clearing out the shed skin and dead bacteria in the ear canal, as well as in directly fighting the infection by interfering with the growth of bacteria.
• Pills may be used in addition to the topical medications.
• Oral antibiotics may be given for severe infection
• Surgical removal of dead tissue may be required to treat malignant otitis externa
• Codeine or narcotics may be prescribed to relieve severe pain
• Analgesics may be used if pain is severe. Putting something warm against the ears may reduce pain.
• Using over-the-counter drops of a dilute solution of acetic acid or alcohol in the ears after getting them wet can help prevent otitis externa.
• Use antiseptic eardrops whenever the water is trapped in the ears. Such eardrops are inexpensive and sold without prescription under various trade names such as Aqua Ear, Ear magic or Swim Ear.