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1994-01-17
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$Title{Otitis Externa}
A Medical Times Patient Education Chart
(C) Romaine Pierson Publishers, Inc.
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Otitis Externa
Water Gets Trapped in the Ear
Otitis externa is brought on by too much moisture in the external
auditory canal. This passageway leading from the outer ear opening to the
eardrum is approximately one inch long. The lingering moisture softens and
wears away the skin lining the outer ear canal, making it more susceptible to
infection, usually by bacteria and occasionally by a fungus.
Often the excess moisture is the result of water entering the ear during
diving or swimming, giving the condition its common name of "swimmer's ear."
Otitis externa can also be caused by hair spray or hair dye, or by aggressive
cleaning of the ear with a cotton swab. Dead cells from the skin lining the
ear are naturally edged outward, taking with them other accumulated debris,
but inserting a cotton swab pushes these substances back into the ear. The
debris and cerumen (commonly called earwax) can trap water or other sources
of moisture in the canal.
Otitis externa can also be caused by a furuncle, a boil resulting from an
abscess of a hair follicle in the ear. If you have allergies or skin
conditions, such as eczema or psoriasis, you may be more likely to develop
otitis externa.
Signs and Symptoms
Symptoms of otitis externa include itching, burning, and pain. Furuncles
can be particularly painful. The skin lining the external auditory canal may
appear red and swollen and the canal may become filled with pus, causing a
bad-smelling discharge and temporary loss of hearing.
Ear Drops and Analgesics
Because of the possibility of pushing the pus and debris farther into the
ear, removal of accumulated material should be left to your doctor, who may
remove it with irrigation, suction, or dry wipes. Ear drops may then be
instilled. These drops may be an acetic acid and water solution (acetic acid
is the principal acid in vinegar) or a combination of cortisone-like drugs to
reduce the swelling and antibiotics to destroy the bacteria. Codeine or other
analgesics may be needed for pain relief. Oral antibiotics may be needed,
especially if there is spreading cellulitis, a bacterial infection that can
penetrate deep into the skin and have more widespread effects on other parts
of the body.
Due to the severe pain associated with furuncles, analgesics are almost
always prescribed. Furuncles should be allowed to drain naturally and while
draining will discharge a bloody pus. They should not be pierced to produce
drainage, since this could cause a spreading inflammation. Applying drops is
not effective for furuncles.