Otitis Externa

Condition

• Otitis Externa

Definition

• Inflammation of the ear canal
• Can be caused by bacterial (e.g. streptococcus or pseudomonas) or fungal (aspegillos niger or candida species) 

History

• pain 
• discharge
• no recent upper respiratory tract infection
• predisposing factors: swimming, trauma, known narrow ear canal and past history of exostoses
• itchiness and skin scaling from ear canals this could suggest underlying skin diseases e.g. eczema

Examination

• otoscope 

DDx

• Malignant otitis externa 
• potentially life threatening infection of the external ear and skull base
• most commonly presents in elderly patients, diabetic patients and the immunocompromised 
• usually presents with unrelenting otalgia over several weeks 
• examination will show ear discharge, granulation tissue visible in the floor of the external ear canal. 
• There may be facial nerve or other lower cranial nerve involvement
• needs urgent referral 

Treatment

• Ear canal debridment
• Keep ear dry 
• Ear drops
• Oral analgesia
• Treatment of underlying skin disorder

References

1. Hawke library