Skip to main content

Acute Otitis Externa | Aetiology | Symptoms | Diagnosis | Treatment | Prevention

Acute otitis externa is the acute inflammation of the external auditory canal. It may be generalised or localised. 
The localised variety presents as a furuncle in the ear. The generalized type may be infiltrative with thickening of tissues or it may be desquamative. 

 Aetiology :
  • It occurs at any age.
  • Water entering the ear may carry with it organisms which may cause acute otitis externa. 
  • Damp climate may also cause it. 
  • Scratching the ear causes abrasions which may get infected. 
  • Discharge from the middle ear may cause a secondary infection of the external auditory canal. 
  • Diabetes may cause severe otitis externa which is very painful and also leads to paralysis. 
Pathology :
  • A furuncle is usually a staphylococcal infection affecting a hair follicle or a sebaceous gland. 
  • Generalized otitis externa is the result of staphylococcal, streptococcal or gram-negative bacillary infection.
Symptoms :
  • Pain in the presenting symptom which may be severe as the skin is intimately adherent to the underlying cartilage. 
  • Otorrhoea : When the furuncle raptures, purulent discharge starts flowing. Generalized otitis externa may also produce otorrhoea. 
  • Tinnitus is present at times. 
  • Itching is often present. 
  • Trismus is likely to be present when the lesion involves the anterior canal wall.
  • Deafness may be present due to the collection of discharge and debris in the external canal. 
Signs :
  • Swelling: The furuncle causes localized swelling, while diffuse otitis externa leads to generalized swelling. 
  • The furuncle may be single or multiple. 
  • The external auditory canal becomes congested, oedematous and stenosed. 
  • A discharge may be present in the external canal. 
  • Tenderness: Movements of the pinna are extremely tender, and there is tenderness below and in front of the ear. 
  • Trismus may be present. It is accompanied by severe pain on opening the mouth. 
  • External auditory canal: A furuncle occurs in the outer parts of the external auditory canal. When it ruptures, it starts discharging pus and may be covered with a granuloma. 
  • Generalized otitis externa causes diffuse inflammation of the ear canal. 
Differential diagnosis :
  • Acute otitis externa and acute mastoiditis: Acute otitis externa should be differentiated from acute otitis media and mastoiditis. 
  • Wax is very common and is characterised by the presence of a brownish or blackish mass filling the external ear canal. 
  • Keratosis obturans is a blackish mass of wax is seen in the ear canal surrounded by exfoliated debris containing cholesterol. Granulations usually surround the wax and debris. The mass causes erosion and widening of the bony canal. The eardrum is usually not involved. 
  • Fungus infection gives rise to itching in the ear. Initially, there is cotton-like growth of fungus, and later a wet newspaper like mass is present. 
  • Referred pain: The ear is normal, while the pain is referred from a problem elsewhere. 
Treatment :

Local :
  • Fomentation is soothing to the patient. 
  • Antibiotic ear drops useful when purulent discharge is present. 
  • Drops containing antibiotics with steroids are helpful in reducing oedema. 
  • Water should not be allowed to enter the ear. 
  • Cleaning: The secretions and the collected debris should be removed.
  • 10% Ichthammol in glycerin: Packing the ear with a gauze strip soaked in Ichthammol glycerin is very soothing. Glycerine reduces oedema and pain, whereas Ichthammol is in antiseptic. 
  • Incision and drainage of the furuncle: If the pain is very severe and the furuncle is not rupturing, incision and drainage may be performed for prompt relief from pain. 
  • Care should be taken not to deepen the incision to the cartilage, as it may precipitate perichondritis. 
General : 
  • Antibiotics are administrated for controlling the infection. 
  • Analgesics: Sometimes very strong analgesics are required if the pain is very severe. 
  • Diabetes, if present, should be treated. 
Prevention :
  • Water should be prevented from entering the ear. 
  • Scratching of the ear should be avoided. 
Labels:

Popular posts from this blog

What are the complicatios of piles?

Piles can be chronic and painful, but complications of piles are rare. Rarely, a thrombosed type of piles may rupture. If they do happen, they might include the following complications.  depending on their cause . Let us check out some complications of piles in this article.  The complications of piles include: Anemia:  They can deprive your red blood cells of oxygen if hemorrhoids bleed too much. This can cause fatigue, shortness of breath, headaches, and dizziness as your body's supply of blood carries less oxygen. Prolapse: When you sit or pass a bowel movement, prolapsed hemorrhoids may cause pain or discomfort. Blood clots:  Thrombosis is more likely to be an actual hemorrhoid problem. Blood clots can cause discomfort and scratch increasingly unbearable. Hygienes: Piles cause complications associated with hygiene, as the anal area become difficult to clean after the defection. Several infections:  Bacteria may become bleeding hemorrhoids and infect the
Read more

Difference between PLMD and RLS

PLMD is known as Periodic limb movement disorder and RLS is known as Restless Leg Syndrome are sleep disorders that both appear to be the same thing conditions are characterized by a sleeper not being able to keep still. However, these two sleep disorders are distinctly different. Diagnosing which condition a patient might be suffering from is important is to determine what the best course of treatment might be.  What is PLMD? PLMD is the condition in which the legs twitch every 20 to 40 seconds while a person in sleep is an involuntary action that the person is not aware of.  What is RLS? RLS is the condition in which the patient has an urge to move the legs or arms, which often happens when they are sitting or trying to get sleep. It is a nervous system disorder that is also known as Willis-Ekbom disease.  Let us have a deep insight into the difference between PLMD and RLS.  Difference between PLMD and RLS :  PLMD entails an involuntary contraction of the s
Read more

Can homeopathic cure piles permanently?

Yes, Homeopathic medicine for piles cures patients with piles. By comparison to traditional drugs, homeopathy has its medicines proven on humans where the medications are proven on lower animals. Homeopathic medicines, therefore, have proof of specific action on hemorrhoids / Piles disease that serves as justification or significant explanation for the effectiveness of homeopathic medicines in the care of piles patients. The homeopathic practitioner considers the structure of a patient that suffers from the piles and the medical examination of the chosen treatment on the plexus and rectum hemorrhoids sphere.   Specific homeopathic remedies are also prescribed for hemorrhoids such as Aesculus, Nux Vomica, etc, but this treatment should only be used under medical supervision. The treatment of piles is done without surgery and without hospitalization with homeopathic. The homeopathic doctor recommends a particular diet based on the pile's constitution of the patient. 
Read more