Otitis externa is the inflammation of the external auditory canal.
Causes of External Otitis
- Water in the ear (swimmer’s ear)
- Trauma to the skin of the ear canal permitting entrance of organisms into the tissues
- Systemic conditions like vitamin deficiency and endocrine disorders
- Bacterial (Staphylococcus aureus and pseudomonas) and fungal infection (Aspergillus)
- Dermatosis such as psoriasis, eczema seborrheic dermatitis
Clinical Manifestations
- Pain discharge from the external auditory canal
- Aural tenderness usually not present in the middle ear infection
- Occasionally fever, cellulitis and lymphadenopathy
- Pruritus and hearing loss of feeling fullness in the ear
- Discharge may he yellow green and foul smelling
- In fungal infection, hairlike black spores may be visible
Assessment and Diagnostic Findings
- Otoscopic exam: ear canal is erythematous and edematous
- Culture of the discharge may show bacterial or fungal infection
Medical management
- Main aim is to relieve discomfort, reduce swelling, and eradicating the infection
- Patients may require analgesics for the first 48 to 96 hours
- Antimicrobial or antifungal otic medications given by a dropper at room temperature
- Combination of antibiotic and corticosteroids may be used to soothe the inflamed tissues
Nursing Management
- Instruct the patient not to clean the external auditory canal with cotton- tipped applicators and to avoid events that traumatize the external canal such as scratching the canal with the fingernail or other objects
- Patients should avoid getting the canal wet when swimming or shampooing the hair
- A cotton ball or lamb’s wool can be covered in a water-soluble gel such as petroleum jelly and placed in the ear as a barrier to the cabal getting wet.
- Infection can be prevented by using antiseptic otic preparations after swimming unless there is a history of tympanic membrane perforation or a current ear infection
- Place alcohol drops in the external canal to act as an astringent to help prevent infection after water exposure
- If otitis externa is diagnosed refrain from any water sport activity for approximately 7 to 10 days to allow the canal to heal completely
