Otitis externa is an inflammation and/or infection of the ear canal. The ear canal is the tube leading from the outer ear to the eardrum. Because it is often found in swimmers, particularly in warm, humid climates, it is often referred to as swimmer’s ear.
The Ear Canal
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Otitis externa is caused by infection, chemical irritation, or trauma. Trauma causes damage to the ear canal, which may cause inflammation or allow infection to invade.
Factors that may increase your chance of getting otitis externa include:
People with weak immune systems or who have a chronic illness, such as diabetes or AIDS, may suffer an aggressive form called malignant otitis externa. Malignant otitis externa results in infection of the cartilage and bone around the ear, as well as between the ear and the brain (the skull base). The condition can be severe and difficult to treat, causing nerve paralysis.
Otitis externa may cause:
Your doctor will ask about your symptoms and medical history, and perform a visual exam of the ear, including the ear canal and inner ear, using a lighted device called an otoscope. If malignant otitis externa is suspected a CT scan may be necessary.
This condition can easily be treated but can become serious, even life-threatening in some people, if left untreated. This can be very serious particularly in people with diabetes, where the infection can spread and cause malignant otitis externa.
Talk with your doctor about the best treatment plan for you. Options may include:
If you have an infection, medication will depend on the cause of the infection. Other medications will help reduce other symptoms, such as pain and inflammation. Your doctor may recommend:
If the ear canal is very swollen, it may not allow the ear drops to get in. A small sponge, called a wick, may be inserted in the ear canal to absorb the drops. It is usually removed after 24-48 hours.
If medications or ear wash do not work, your doctor may need to remove any drainage or pus from the ear canal. However, this is rarely needed.
Malignant otitis externa requires immediate treatment, hospitalization, intravenous antibiotics, and possibly surgery. Surgery may be indicated for:
Debridement, the removal of dead tissue, may also be necessary to help the healing process.
Your doctor may also recommend:
If you are diagnosed with otitis externa, follow your doctor's instructions.
To help reduce your chance of getting otitis externa, or from having the condition recur, take these steps:
American Academy of Family Physicians
American Academy of Otolaryngology—Head and Neck Surgery
Canadian Society of Otolaryngology
Block SL. Otitis externa: providing relief while avoiding complications. J Family Practice. 2005;54(8):669-676.
National Center for Emergency Medicine Informatics. Otitis externa (swimmer's ear). National Center for Emergency Medicine Informatics website. Available at: http://www.ncemi.org/cse/cse0302.htm . Accessed November 10, 2010.
Otitis externa. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated January 7, 2013. Accessed August 29, 2013.
Rutka J. Acute otitis externa: treatment perspectives. Ear Nose Throat J. 2004;83(9 Suppl 4):20-21;discussion 21-22.
Swimmer’s ear. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/swimmersEar.cfm . Accessed August 29, 2013.
Swimmer’s ear(otitis externa). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Updated February 15, 2013. Accessed August 29, 2013.
Last reviewed September 2013 by Michael Woods, MD
Last Updated: 9/30/2013