External Otitis (External Auditory Canal Furuncle, Diffuse Otitis Externa, Otitis Externa, Swimmer's Ear Disease)

External Otitis
Body Parts: Head
Medical Subjects: Ear, Nose And Throat

What Is The Disease Of External Otitis?

Otitis externa, also known as swimmer's ear disease, is a diffuse inflammation of the skin and subcutaneous tissue of the external auditory canal, caused by various bacterial, fungal infections or allergens irritating the external auditory canal, and ear trauma.

The typical manifestations are earache, pus and itching. Among them, acute bacterial infection is the most common cause and is not contagious. The main treatments for otitis externa include: cleaning the external ear canal, treating inflammation and infection, and controlling pain.

If not treated in time, the infection may spread, causing infection of surrounding tissues, cellulitis and malignant otitis externa, and even parotitis, meningitis, brain abscess and even brain softening, etc.

Otitis externa is common, occurring in 10% of people and more common in children.


What Are The Common Causes Of External Otitis?

  1. Water in the external auditory canalm, People who often swim should pay attention.
  2. The pus of suppurative otitis media irritates the external auditory canal for a long time.
  3. Skin damage to the external auditory canal, such as digging earwax with a harder tool.
  4. Patients with diabetes or the elderly, their local resistance of external auditory canal is relatively low.
  5. Wear hearing aids, earphones or diving helmets for a long time.
  6. Wearing earrings, ear studs, etc. caused local allergies.
  7. Chemical substances in various cosmetics and shampoos stimulate the external auditory canal.
  8. People suffering from psoriasis and atopic dermatitis are more susceptible to external otitis.
  9. People who have received radiotherapy.

The above reasons are more likely to cause infections of various bacteria or fungi and other pathogens.


Symptoms Of External Otitis

What are the common manifestations of external otitis?

  • Pain: I feel the ear pain is obvious, sometimes it becomes very strong, and the tragus is also painful when touching it. When the mouth is opened and chewing, the ear pain will increase, and sometimes even the head pain on the same side may be felt. There may be a small amount of secretion flowing out of the external auditory canal.
  • Itching: Sometimes the external auditory canal may feel itchy. Sometimes there is yellow-white foul-smelling discharge.
  • Others: At the same time, it may be accompanied by symptoms such as fatigue and fever. Some have tinnitus, hearing loss, and ear fullness.

How does external otitis begin?

When water enters the external auditory canal, skin trauma or resistance becomes worse, the skin barrier function of our external auditory canal decreases, and bacteria will invade the skin of the external auditory canal and cause skin inflammation.

What types of external otitis can be divided into?

According to the patient's self-feeling symptoms and the severity of inflammation of external auditory canal examined by doctors, external otitis can be divided into:

Mild otitis externa: slight pain or discomfort or itching of the external auditory canal, the doctor may find that there is slight redness and swelling of the skin of the external auditory canal.

Moderate otitis externa: More obvious symptoms such as pain or itching, the doctor will find that the skin of the external auditory canal is obviously swollen, and the external auditory canal is blocked, but not completely blocked.

Severe otitis externa: Severe pain in the external auditory canal, which is obviously aggravated when opening the mouth or chewing, and may be accompanied by fever, general malaise, headache on the same side and other symptoms, or itching is obvious. The doctor's examination showed that the skin of the external auditory canal was swollen, and the external auditory canal had been completely blocked. At the same time, there was redness around the ear, and the lymph nodes on the same side might also be swollen and painful.


How Is Otitis Externa Diagnosed?

  • More obvious symptoms: obvious ear pain, external auditory canal may have a small amount of secretion out. May be accompanied by fatigue, fever and other symptoms. Sometimes you may feel itchy external auditory canal, and some may have tinnitus, hearing loss, and stuffy ear distension.
  • You have had ear infection before, have had ear surgery before, have recently worn hearing AIDS, have recently injured the external auditory canal with hard objects, and have had water in ears recently.
  • The doctor's examination revealed that there may be redness in the auricle and tragus. If there is pain when pressing the tragus or pulling the pinna.
  • Otoscopy shows that the external auditory canal is usually red and swollen, and various secretions or earwax can also be seen, and the tympanic membrane may also be red.

Those who meet the above conditions can generally be diagnosed.

What examinations need to be done for external otitis?

  • Routine blood test: it helps to diagnose whether there is bacterial infection.
  • Otoscopy: clearly see the severity of inflammation of external auditory canal
  • Cultivation of the secretions of the external auditory canal: Use a small cotton swab to take a part of the secretions from the external auditory canal and send it for examination, mainly to clarify the specific infection caused by bacteria or fungi.

How To Prevent External Otitis

External otitis can be prevented. Specific measures are as follows:

  1. When cleaning earwax, try not to use hard objects to dig your ears to avoid skin damage to the ear canal.
  2. People who often swim should deal with the water in the external auditory canal in time. Use a hair dryer to dry their ears. Try not to use cotton swabs.
  3. Those engaged in water sports should use earplugs.
  4. Do not wear hearing aids, earphones, etc. for a long time. Hearing aids should be taken off at night, and the hearing aids should be cleaned frequently.
  5. People with diabetes should actively control blood sugar.
  6. People with suppurative otitis media should treat otitis media in time and keep the external auditory canal clean.
  7. When using daily necessities such as shampoo, conditioner, cosmetics, etc., avoid entering the external auditory canal.

What should patients with external otitis pay attention to in diet?

  • There are no special taboos in diet, just a healthy and balanced diet.
  • When cooking, pay attention to adding less salt, less oil, less seasoning with high salt content, and less stale meat.
  • There should be a variety of staple foods. In addition to pasta, whole grains, beans, potatoes, etc. can also be used as staple foods.
  • The first choice for meat is chicken, duck, fish, etc., eat less fat.
  • If you are a vegetarian, you can eat more beans and soy products to supplement protein.
  • Eat more fruits and vegetables.
  • Try not to drink alcohol.

What should patients with external otitis pay attention to in life?

  • During the recovery period of otitis externa, it is necessary to avoid water in the ears. When taking a bath, place a cotton ball coated with petroleum jelly in the ear canal to prevent water ingress.
  • You should not swim during otitis externa.
  • Do not wear hearing aids and earphones during otitis externa.
  • Avoid picking ears.

What Are The Treatments For External Otitis?

Bacterial external otitis:

  • Systemic antibiotics are used to control infections.
  • You can take sedative and analgesic drugs for symptomatic treatment.
  • With the assistance of an otoscope, remove cerumen, purulent secretions or dander in the ear canal, and flush the ear canal with hydrogen peroxide.
  • Use antibiotic ointment or hormone ointment locally in the external auditory canal.

Fungal external otitis:

For local antifungal treatment, use 1% clotrimazole solution, or other antifungal cream or ointment, and apply it to the ear canal.

For refractory, antifungal drugs can be taken orally.

Can otitis externa be completely cured?

External otitis can be completely cured by timely treatment.

Will external otitis recur after treatment? What should I do if I relapse?

External otitis may be re-infected and recurred. If it recurs, go to the hospital immediately, and provide timely and standardized treatment after a clear diagnosis.


What Diseases Are Easy To Confuse With External Otitis?

Allergic contact dermatitis of the external auditory canal: Allergy caused by the topical use of certain drugs, cosmetics or shampoo in the external auditory canal. The main symptom is itching. A patch test can be used to help identify allergens.

Chronic suppurative otitis media: mainly manifested as purulent secretions in the external auditory canal, with ear pain, hearing loss, tinnitus or dizziness. However, there is generally no traction pain of the tragus, and there may be obvious perforation of the tympanic membrane. If necessary, an ear CT can be used to help the differential diagnosis.

External auditory canal cancer: If there is a foreign body growing in the external auditory canal, or long-term otitis externa treatment is not effective for the patient, this disease should be considered. The common symptoms are mild pain and bloody secretions in the external auditory canal. Medical examination can differentiate and confirm the diagnosis.

Psoriasis of the external auditory canal: Psoriasis may occur in the external auditory canal, causing redness and dander in the external auditory canal. Medical examination can help distinguish the diagnosis.


What Are The Complications Or Serious Consequences Of External Otitis?

External otitis inflammation spreads to the surrounding area, causing cellulitis around the ear

If diabetics or elderly people cause external otitis due to bacterial infection, they may develop malignant external otitis, also known as necrotizing external otitis, which is a serious and potentially fatal complication of acute bacterial external otitis.

The spread of external otitis infection may also cause mumps. After spreading to the bottom of the brain, it may cause meningitis, brain abscess, encephalomalacia and even death.

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