External Otitis

External Otitis

Otitis externa is an infection that occurs in the outer ear canal. This ear infection can occur due to the entry of water into the ear when bathing or swimming. Water that can't get out will cause the ear canal to be moist, thus triggering the growth of bacteria.

Normally, earwax (cerumen) functions to prevent the growth of bacteria that can trigger ear infections. However, if water enters the ear canal repeatedly, the risk of getting an ear infection or otitis externa can increase.

Otitis externa attacks the outer ear canal, which is the part between the ear canal and the eardrum . These ear infections are more common in swimmers. Therefore, otitis externa is also known as swimmer's ear .

Causes of Otitis Externa

Otitis externa is generally caused by infection with the bacteria Staphylococcus aureus or Pseudomonas aeruginosa . These bacteria can develop in the ear due to the following factors:

  • The condition of the ear canal that is too damp, either due to excessive sweating, damp weather, or water getting into the ear
  • Scratches or scratches on the ear canal, for example as a result of scratching the ear canal with a finger, cleaning the ear with a cotton bud , using earbuds or hearing aids
  • Irritation or allergic reaction, for example due to the use of hair care products or shampoo that accidentally enters the ear canal
  • Skin diseases that can attack the ear canal, such as dermatitis and psoriasis

Otitis externa can actually also be caused by a fungal infection . However, cases are rare.

Otitis externa risk factors

Several factors that can increase a person's risk of developing otitis externa are:

  • Swimming , especially in places that contain lots of bacteria, such as lakes
  • It has a narrow ear canal that can trap water in the ear
  • Cleaning the ears too often or too hard can cause the inside of the ear to be scratched
  • Frequent use of hearing aids or earbuds
  • Suffering from allergies or skin irritation

Symptoms of Otitis Externa

Based on the severity, the symptoms of otitis externa can be divided into three, namely mild, moderate and severe. In early or mild conditions, otitis externa generally causes the following symptoms:

  • Itching and redness in the ear canal
  • Watery ears or clear fluid or pus coming out of the ear
  • Pain when the protrusion in front of the ear canal (tragus) is pressed or when the ear is pulled

Meanwhile, at a moderate level of severity, otitis externa sufferers may experience complaints in the form of:

  • The ear canal feels full and looks like it is blocked due to swelling or too much earwax and fluid
  • Hearing ability decreases

If not treated immediately, the infection will spread so that the symptoms will get worse. In severe or severe conditions, symptoms that appear include:

  • Worse itching
  • The auricles become red and swollen
  • Pain in the ear radiating to the face, neck and head
  • Swollen lymph nodes in the neck
  • The ear canal is completely blocked
  • Fever

When to see a doctor

Check with your doctor if you experience the symptoms mentioned above, especially if the pain gets worse. Detection and treatment need to be done early to reduce the risk of complications.

Immediately seek medical help to the nearest hospital emergency room if you experience symptoms of otitis externa accompanied by complaints in the form of:

  • Severe pain
  • Fever
  • Decreased ability to hear
  • vertigo

Diagnosis of Otitis Externa

First of all, the doctor will conduct questions and answers about the symptoms and habits of the patient, especially habits that are at risk of causing otitis externa.

Next, the doctor will examine the ear by gently pulling the earlobe and pressing on the protrusion in front of the ear (tragus). This examination is also carried out to find out if the patient feels pain.

The doctor will also look at the patient's ear canal and eardrum with an otoscope, which is a special tool in the form of small binoculars equipped with a light. This examination can help the doctor to determine the severity of otitis externa.

If necessary, the doctor will take fluid samples from the patient's ear canal for examination in the laboratory. Through this examination, the doctor can find out the type of bacteria that causes the infection and the right antibiotics to kill these bacteria.

Treatment of Otitis Externa

To treat otitis externa, the doctor will first clean the patient's ear canal. The doctor can use a curette or a special instrument to remove wax from the ear. This is done so that the ear drops that will be prescribed can seep into all the infected parts

After that, the doctor will give medicines to treat otitis externa. These drugs include:

  • Corticosteroids , to relieve inflammation in the ear canal
  • Antibiotic ear drops, such as polymyxin B ear drops , to kill infections caused by bacteria
  • Antifungal ear drops, to eradicate infections caused by fungi
  • Acidic solution , to normalize the pH level in the ear canal and relieve inflammation
  • Painkillers, such as ibuprofen or paracetamol
  • Take antibiotics if the infection gets worse and attacks the skin around the ears

To speed up the healing process, patients will be advised to avoid the following activities:

  • Swim or dive
  • Take a shower without covering your ear canals first
  • Using hearing aids or earbuds before they are completely healed
  • Travel by airplane

Complications of Otitis Externa

Otitis externa if not treated properly can cause complications in the form of:

  • Temporary hearing loss
  • Long-term infection (chronic external otitis), for example due to antibiotic resistance in the bacteria that cause it
  • Infection that spreads to the bone around the ear canal ( osteomyelitis )
  • Infection of the inner layer of skin around the ear ( cellulitis )

Prevention of Otitis Externa

There are several efforts that can be made to prevent otitis externa, namely:

  • Use ear protection when bathing or swimming to prevent water from getting into your ears.
  • Dry the outside of the ear after showering or swimming.
  • Tilt your head when the water gets into the ear to let the water out.
  • Consult your doctor first before swimming if you have just recovered from an ear infection or have just had ear surgery.
  • Do not insert objects that can cause cuts or scratches on the lining of the ear canal.
  • Do not use a cotton swab to clean the ear canal, because it will push the dirt deeper.
  • Don't pick your ears with your fingers or other objects.
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