Otitis Externa

What Is Otitis Externa?

Otitis externa is an inflammatory condition of the external ear and ear auditory canal. Also known as swimmer’s ear, this is a very common condition that causes ear ache. Otitis externa can be caused by bacterial infections or non-bacterial causes like dermatitis, fungi and mechanical trauma. Bacterial infections often develop after swimming in a swimming pool or after manipulating your ears with dirty fingers or objects. Mechanical trauma to the ear can include using cotton swabs and metal ear picks. These cleaning devices actually do more damage than cleaning because it can push earwax further into the ear canal causing blockage of the ear canal. When the ear canal is blocked, fluid in the ear and other debris cannot exit the ear which causes more inflammation and can result in conductive hearing loss.  The bacterial organisms that cause this infection is Pseudomonas aeruginosa, Staphylococcus aureus while usual fungal pathogens are Candida albicansand Aspergillus.

Who Can Get It?

Anyone can get otitis externa and almost everyone in their lifetime will experience an episode. Those who are exposed to swimming in pools or those living in humid areas are at higher risk for developing otitis externa. Those who frequently clean their ears using cotton swabs and other ear picking devices are also at higher risk for developing this. Frequent cleaning which is defined as more than once a week rids the ear canal of ear wax which has a protective function. Loss of ear wax can make the ear susceptible to the growth of bacteria and fungi which causes infections.

What Are The Symptoms?

The primary complaint is always ear pain. Slight tugging of the outer ear is already enough to cause intense pain. Patients with otitis externa are usually apprehensive to have their ears examined because of the pain. The pain is enough to cause problems with sleeping and doing daily activities. When the physician is able to examine the ear using an otoscope, the ear canal looks red and inflamed, sometimes with flakes of skin. Ear discharge which usually presents with orange crusting is also associated with otitis media. If fungal infections occur, itching can also be felt.

How Is It Diagnosed?

Diagnosis is done by the physician after taking a good history of the patient and after a quick examination of the ear. Diagnosis of otitis externa is quick and easy and no diagnostic tests and laboratory exams are needed except when complications are suspected. Through observation and palpation of the outer ear, the physician already has a diagnosis of otitis externa. It is further confirmed through otoscopy wherein the physician inserts a device into the ear to visualize the ear canal.

How Is It Treated?

Otitis externa is highly treatable and has a good prognosis. The first step in treatment usually involves the physician repeatedly cleansing an drying the ear canal. This is to rid the ear of discharge and debris due to the infection. After which, the ear canal is irrigated with an antiseptic. Antibiotic ear drops are also given to get rid of the infection and to reduce the inflammation. For severe cases of otitis externa, steroid can be given to help reduce the inflammation, however, this is contraindicated for patients with fungal infections or perforated ear drums.

How Can It Be Prevented?

This is simply prevented by drying your outer ears with a clean towel after each bath. Cleaning the ears using cotton swabs is not recommended as this can push ear wax further into the ear canal. It can also be prevented by not swimming in dirty pools or polluted bodies of water.