Ear canal is the only skin-lined cul-de-sac in the body

Acute - Symptoms < 3/52
  • Typically unilateral
  • 90& bacterial, 2% fungal
Chronic - Symptoms > 3/52
  • Often bilateral
  • White keratin debris may fill the ear over time
  • Allergic dermatitis to shampoos/cosmetics etc
  • Treat underlying cause

Causes/Factors

  • Swimming

  • Trauma

  • Occlusive ear devices

  • Allergic Contact Dermatitis

  • Dermatological conditions

  • Pseudomonas aeruginosa

  • Staphylococcus aureus

Symptoms

  • Inflammation of the external ear canal presenting with a combination of otalgia, pruritus and non-mucoid ear discharge

Diagnostic Tests

  • History
  • Otoscopic examination
  • Ear swab or pus sample for MC&S

Management

Complications/red Flags

  • Pseudomonas bacteria causing a necrotising OE life threatening

Malignant otitis externa - infection has spread to the temporal Bone. Additional risk factors are diabetes, Immunosuppression, HIV. Can lead to:

  • facial nerve damage
  • cranial nerve involvement
  • Meningitis
  • intracranial thrombosis
  • death