Otitis Externa

Overview/prevalence

Otitis externa, also known as swimmer's ear, is due to inflammation in the external auditory canal. The most common cause is due to bacteria, however other causes include infectious, allergic and dermatologic. It is more common in the summer months. 

Risk Factors 

The risk factors include swimming, trauma (scratching or excessive cleaning), earphones, hearing aids, or rashes in the ear. 

Symptoms

Otitis externa may present with ear pain, itching, discharge and hearing loss. 

On physical examination there may be pain with pushing on the ear tragus or manipulating and pulling on the auricle.

On otoscopic exam there may be swelling and redness of the ear canal. The tympanic membrane may also be red.

Diagnosis

The diagnosis of otitis media is based on history and physical exam. 

Treatment

The first step in treatment is to clean out the ear canal.

The treatment choice is dependent on the severity of the symptoms. Treatments may include an acidifying agent, steroid or antibiotic, sometimes a combination may be a given. Hearing aids or earbuds should not be used until resolution of symptoms. Water should be avoided in the ear during treatment. 

Complication 

Malignant otitis externa is a potentially fatal complication of otitis externa. On imaging there will be extension of the infection into the bony structures. 

Prevention

Using earplugs during water sports may help prevent otitis externa. After water exposure blow drying the ear and shaking out the water may also help to prevent otitis externa.