Chronic Otitis Externa

Overview, Causes, & Risk Factors

Chronic otitis externa is a persistent inflammation of theear canal.

What is going on in the body?

Chronic otitis externa occurs when there is persistent traumato or inflammation of the ear canal. This can occur for different reasons,such as infection. This persistent inflammation can lead to symptoms.

What are the causes and risks of the condition?

Repeated trauma to the ear canal in the form of Q-tips,bobby pins, or other objects can alter the healthy skin replacementpattern of the ear canal. Fungal or bacterial infections on the surfaceof the ear canal skin can also be a cause. With fungal infections, theskin of the ear canal becomes quite thick, and when peeled off, there issignificant redness of the underlying skin. In certain situations moldmay form on the skin of the ear canal.

Use of some antibioticeardrops that contain neomycin,can cause a chronic inflammation that can be similar topoison ivy.Therefore, these medicines need to be used with some caution.Excessive dryness of the ear canal can also be a factor.

Symptoms & Signs

What are the signs and symptoms of the condition?

One of the most prominent symptoms of chronic outer earinflammation is itching in the ear canal. Other symptoms include low-gradepain and flaky skin. It is rare to find any infected drainage material,severe tenderness, or hearing loss.

Diagnosis & Tests

How is the condition diagnosed?

This condition is diagnosed by examining the outerear structures. Often thinning of the ear canal skin, flaky skin, orflaky, dried, yellow material is present. In fungal forms, the skin ofthe ear canal may be thickened and can easily be removed. Theunderlying skin is often intensely red.

Prevention & Expectations

What can be done to prevent the condition?

Avoidance of trauma to the ear canal will prevent many cases.Many doctors discourage the use of Q-tips and most other objects toclean the ear canal. Keeping the ear canal dry and free of wax willhelp prevent some cases. A simple eardrop solution can work wellto keep the ear canal dry. Avoidance of neomycin-containing drugsmay prevent some cases as well.

What are the long-term effects of the condition?

Most cases do not cause any long-term effects. But where theydo, the main long-term effect would be continued thickeningof the skin of the ear canal to the point where the ear canal isblocked and hearing loss occurs.

What are the risks to others?

There are no risks to others.

Treatment & Monitoring

What are the treatments for the condition?

Treatment depends on the cause of the inflammation.

  • For chronic otitis externa caused by repetitive trauma,treatment involves stopping the trauma to the ear canal. Personsmay be advised to stop using Q-tips, for example.
  • People with fungal forms need to have the surface of thediseased skin removed. Ointments containing antifungal andcorticosteroid medicine may be applied to the ear canal. Othertopical types of therapy may also be used in some cases.
  • If the disorder is caused by chronic bacterial infections,then antibacterial drops often restore the external canal to a normal,healthy state.
  • If dryness is a cause, then several drops of baby oil in theear canal will help to keep the skin moist.
  • For the rare blocked ear canal, the scarred lining of thecanal must be removed and skin grafts placed to reline the bone.
  • What are the side effects of the treatments?

    Side effects depend on the medicine used to treat theunderlying cause. Care must be used if ointment is applied into theexternal canal, particularly if a Q-tip is used, to avoid perforation tothe eardrum and further trauma to the ear canal.

    What happens after treatment for the condition?

    Most cases of chronic otitis externa will completely resolvewith the right treatment. Some people continue to have a need forregular medical management.

    How is the condition monitored?

    How closely the condition is monitored depends on theintensity of the symptoms. A doctor should becalled if any acute symptoms, such as pain, drainage, or tendernessof the ear canal, are present.

    Article type: xmedgeneral

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