Otitis Externa
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Otitis Externa

Otolaryngology

Otitis Externa, or "Swimmer's Ear,"  is a redness or swelling (inflammation), irritation, or infection of your outer ear canal. This condition is typically caused by bacterial infection, especially after water remains in the ear canal, such as after swimming without thoroughly drying the ears. Fungi, allergic reactions, or prolonged skin conditions can also cause Otitis Externa.

Symptoms

The symptoms of Otitis Externa (Swimmer's Ear) include:

  • Ear Pain: This is the most common symptom of Otitis Externa. The pain may worsen, especially when chewing or pulling on the ear.
  • Redness and Swelling of the Ear Canal: The infected area may become red and swollen; sometimes the ear canal may be wholly or partially blocked.
  • Ear Discharge: There may be a clear, yellow, or greenish fluid draining from the ear canal, sometimes containing pus.
  • Itchiness in the Ear Canal: The infected area may feel itchy or burning.
  • Hearing Loss: If the ear canal is swollen shut due to inflammation, it may lead to temporary hearing reduction.
  • Feeling of Fullness or Blockage in the Ear: Infection causing swelling of the ear canal may give a sensation of the ear being clogged.
  • Pain in the Earlobe or Behind the Ear: Otitis Externa may cause the entire ear area, including behind the ear, to feel painful.
  • Swollen Lymph Nodes in Front of the Ear: In some cases, lymph nodes near the infection may become swollen and tender.

Causes and Factors

External otitis is mainly caused by infection of the skin of the external auditory canal. Here are some primary causes and risk factors:

Causes:

  • Bacterial infection is the most common cause of external otitis, especially by bacteria such as Pseudomonas aeruginosa and Staphylococcus Aureus.
  • Fungal infection: In some cases, external otitis may be caused by fungi such as Candida.
  • Skin conditions: Individuals with specific skin conditions such as atopic dermatitis, psoriasis, or contact dermatitis are more prone to external otitis.
  • Injury: Scratching or abrasions of the ear canal, often occurring during attempts to clean the ears using cotton swabs or other objects, can create entry points for bacteria or fungi.

Risk factors:

  • Swimming: People who swim regularly, especially in water with high levels of bacteria, are more likely to develop external otitis, which is why this condition is also known as "swimmer's ear."
  • Damp and humid environments: High humidity and temperature can promote the growth of bacteria and fungi, increasing the risk of infection.
  • Foreign bodies or irritants in the ear canal: Foreign objects or chemicals (such as hair spray or hair dye) in the ear canal may cause irritation or damage to the external auditory canal.
  • Frequent use of headphones or hearing aids: These devices may irritate the ear canal, leading to inflammation or infection.
  • Excessive cleaning: Overuse of cotton swabs or other objects to clean the ears can damage the skin of the ear canal, making it more susceptible to infection.

 

Diagnosis and Treatments

Diagnosis

  • Medical History Inquiry: The doctor will ask about the onset time of symptoms, the frequency of ear contact with water, any similar history of past illnesses, and whether any ear products were used or attempts at self-treatment were made.
  • Ear Examination: The doctor will use an otoscope to examine the external auditory canal and eardrum condition. Inflammation, swelling, discharge, or accumulation of earwax could all be caused by otitis externa.
  • Microbial Culture: If the infection is severe or routine treatments are ineffective, a sample may be taken from the ear canal for bacterial or fungal culture for targeted therapy.


Treatments

  • Cleaning the Ear Canal: The doctor may remove discharge, earwax, or foreign objects from the ear canal to reduce the growth environment for bacteria or fungi.
  • Ear Drops Typically include antibiotics, antifungal medications, and steroids to reduce inflammation. If the external auditory canal is severely swollen, a small cotton strip (ear wick) may be placed first to help the medication reach the entire ear canal.
  • Pain Relievers: Non-steroidal anti-inflammatory drugs (ibuprofen) can help reduce pain.
  • Keeping the Ear Canal Dry: Avoid swimming or submerging the head in water; use earplugs to prevent water from entering the ears while bathing.
  • Avoid Self-Cleaning the Ear Canal: Do not use cotton swabs, fingers, or other objects to clean the ear canal, as this may push earwax deeper or cause further irritation.
  • Controlling Diabetes or Immune System Issues: If the patient has diabetes or immune system issues, managing these conditions can help treat otitis externa.

Prevention

To reduce the risk of infection and inflammation in the external ear canal, here are some preventive measures:

  1. Keep Ears Dry: Moisture can cause bacteria and fungi to thrive, leading to otitis externa. After swimming or bathing, thoroughly dry your ears with a soft towel or use a hairdryer on a low heat setting, keeping it at a proper distance.
  2. Use Earplugs or Swim Caps: Consider wearing earplugs or a swim cap while swimming to prevent water from entering the ear canal.
  3. Avoid Inserting Objects into the Ears: Do not use cotton swabs, hairpins, or other items to clean or scratch the inside of your ears, as this can damage the skin and tissues of the ear canal, leading to infection.
  4. Manage Skin Conditions: If your ears are affected by skin conditions such as eczema or psoriasis, appropriately use suitable treatment methods to prevent inflammation and cracking of the skin in the ear canal.
  5. Use Protective Ear Drops: If you are prone to ear infections or frequently swim or dive, consider using protective ear drops. These drops help dry out and acidify the ear canal, protecting against bacteria and fungi.
  6. Avoid Over-Cleaning: Over-cleaning the ear canal can remove natural oils, leading to dry, cracked skin. Clean your ears gently and only when necessary.
  7. Maintain Good Ear Hygiene: Clean the outer part of the ear with a damp cloth. If earwax accumulation is an issue, consult a healthcare provider for safe removal methods.
  8. Control Diabetes: If you have diabetes, controlling your blood sugar levels can help prevent otitis externa and other infections.
  9. Limit Exposure to Irritants: Avoid using products that may irritate the ear canal, such as hair sprays, perfumes, or other products.

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