WHAT IS OTITIS EXTERNA?
Outer ear infections as the name implies are common infections that affect the skin of the ear canal, causing inflammation (redness and swelling). It can be self-limiting in some patients, however symptoms may be severe enough for you to seek attention from your doctor who may need to refer you to an ENT specialist for further assessment and management, if your condition does not improve with treatment started in primary care.
WHAT ARE THE SYMPTOMS OF EAR INFECTIONS?
The most common symptoms associated with an ear infection include;
pain or ear ache in the ear canal or outer ear,
swollen red, inflamed skin,
ear discharge which may appear bloody or smelly,
blocked ear or deafness,
dizziness or loss of balance
tinnitus (ringing in the ear)
fever or high temperature.
CAUSES OF EAR INFECTIONS
Ear infections are often caused by bacteria, although occasionally it can be attributed to fungal or yeast infections. Allergic reactions, chronic irritation, or some skin conditions such as eczema and psoriasis, may predispose to outer ear infections.
Treatment options are dependent on the cause. Antibiotic or antifungal ear drops can be administered into the ear canal for a period of seven to ten days. Your GP may take an ear swab to test for the exact micro-organisms that are causing the infection before starting you on treatment. Depending on severity of the ear infection, oral antibiotic treatment may be required. Steroid ear drops can also be used to reduce the associated ear canal swelling, and are sometimes found in combination with antibiotic ear drops.
If the ear infection does not settle after 7 to 10 days of antibiotic ear drops +/- tablets, then it is recommended you see an ENT specialist for further assessment. You may need to have the ear canal discharge or debris cleared using a technique called aural microsuction, and a special sponge known as a ‘pope wick’ may need to be inserted into the ear canal and remain in place for a few days to permit the antibiotic ear drops reaching the inflamed ear canal skin.
You will need to keep the ear dry by avoiding water exposure. Repetitive or long-standing ear infections may require further investigations such as a CT scan of the ears, or examination under anaesthetic, to exclude a chronic underlying ear problem.
It is recommended that items such as cotton wool buds or fingers are not inserted into the ears. Use of silicone ear plugs when swimming may also help reduce water exposure to the ear canal that can act as a trigger for recurrent ear infections.