We treat otitis externa in adults and children together at home. Otitis of the external ear - symptoms and treatment of inflammation External otitis of the ear symptoms and treatment
Each of the three sections of the human ear performs its functions depending on the structures that are located in this section. Otitis is called inflammation of one of them, and since the ear is anatomically divided into external, middle and internal, then there are different types of otitis.
Today we will talk about inflammation of the outer ear. You will learn what exactly this section consists of, its main functions, the influence of what factors provoke the occurrence of inflammation, what symptoms may indicate that you have this particular type of otitis and other important information.
The outer ear begins with the pinna and ends with the eardrum, after which the middle and then the inner ear begin. Therefore, the auricle and external auditory canal are included in this section.
The auricle consists of cartilaginous tissue, which is covered on all sides by skin. Thanks to its funnel-shaped structure, the pinna collects and directs sound waves into the deeper structure of the outer ear - the external auditory canal.
The general functions of the auricle are:
The already mentioned capture and transmission of sound waves
protection of the external auditory canal from dust
partial protection from injuries to other parts of the ear due to the shape of the cartilage tissue
The external auditory canal is 2.5–3.5 cm long and is slightly curved in two places. The lumen, up to 8 millimeters in diameter, is lined with skin covered with fine hairs and is equipped with sebaceous glands that produce earwax. The walls of the passage themselves consist of cartilaginous tissue, and underneath there is the bone tissue of the skull.
The functions of the ear canal are as follows:
Conducting sound vibrations into the middle ear
protection of deeper structures from injury and contamination
maintaining a constant temperature that does not depend on the external temperature to ensure normal functioning conditions for the eardrum.
Mechanisms of development of external otitis
Inflammation of the middle ear usually develops as a complication of infectious diseases of the nasopharynx, in which bacteria enter the ear through the auditory tube connecting it to the nose. Otitis externa, in turn, may have nothing to do with any other diseases. Let's start with its first type, which is characterized by a milder course.
Limited external otitis
As we already wrote in the section “Structure of the external ear,” there are small hairs in the ear canal that perform a protective function. Due to the fact that a constant, fairly high temperature and humidity are constantly maintained in the passage, and its walls are covered with earwax, the risk of inflammation of the hair follicle increases slightly. In this case, a painful boil is formed, which cannot be seen without special tools. This type of inflammation is not difficult to distinguish from other, more serious ones - the pain is localized quite close to the auricle and goes away on its own after a few days, when the boil bursts and pus flows out.
Diffuse external otitis
Depending on the cause of inflammation, diffuse otitis of the external ear is divided into three types:
Bacterial
allergic
fungal
The bacterial type can develop as a consequence of bacteria entering a wound in the ear, caused, for example, by an ear cleaning stick or any other object that accidentally gets into the ear canal. Then microorganisms multiply rapidly at the site of damage, creating a focus of inflammation.
Allergic otitis media usually manifests itself in local allergic reactions when a substance that a person cannot tolerate gets into the ear. The possibility of developing external otitis due to a general allergic reaction is small.
Fungal otitis media develops when a fungus gets into the ear. It is easy for microorganisms to take root in an environment with high humidity and a comfortable temperature, so such infection is possible even without injuries to the external auditory canal.
Who is particularly at risk for otitis externa?
We will include children in the first group. They are very likely to damage the ear, either with their nails or with any other object found in the house. Even at the age of several months, a child can scratch himself if his hands are not wearing protective gloves. You can prevent the development of external otitis in children if you notice in time that the child has stuffed some object into the ear, carefully remove it and disinfect the ear canal (do not use alcohol for this!). You can drip a solution of 3% hydrogen peroxide and boiled water in a ratio of approximately 1:1 into your ear, or lubricate it with a small amount of brilliant green.
The second group will include people whose work involves dust and other types of air pollution. Particles flying in the air settle on the external auditory tube and large quantities can also lead to inflammation. To avoid it, work with special headphones and every day, after finishing work, simply wipe your ears with a slightly damp cotton swab.
And the third group is adults who like to use objects not intended for this purpose to clean their ears. The most popular here are matches or toothpicks, on which a piece of cotton wool or gauze is wound. In the process of cleaning the ear canal, the sharp tip of a toothpick or one of the cut edges of a match can easily pass through cotton wool or gauze and scratch the skin on the ear. Moreover, the scratch can be so small that you won’t even notice its appearance. But the protective layer of the ear is broken and now any bacteria that gets into it is likely to lead to inflammation. It's easy to avoid - don't use anything other than soft cotton swabs to remove earwax and don't stick them too deep. If this happens and you don’t have them, then at least moisten cotton wool or gauze with a small amount of a mild antiseptic and be careful during the procedure. 
Symptoms of otitis externa
Often this type of otitis does not go away as acutely as internal or medial, but it also causes a lot of trouble. You may need to start treatment for otitis media if you have
The ear constantly hurts in a place located closer to the auricle
the ear canal swells, the lymph nodes in the ear area become enlarged
itching in the ear
discharge of pus or other unusual fluid
Treatment of external otitis
It is not difficult to cure it in a non-advanced stage. Most often, products applied to the turunda or anti-inflammatory antibacterial ointments without antibiotics are used. Turunda can be soaked in boric alcohol, or its mixture with Dimexide in a 1:1 ratio. Afterwards it should be left in the ear for about an hour. This method is often effective, but if there is a wound or boil in the ear it can cause severe pain, so it is still better if a doctor prescribes medications for the treatment of otitis after examining the ear and determining the damage that is present in it.
Otitis externa is actually quite a serious disease; this article was written for informational purposes. We strongly recommend that at the first signs of otitis media you contact a qualified specialist for advice and prescribe the correct treatment.
Otitis externa is a disease of the outer part of the hearing organ, which consists of the concha, ear canal and tympanic region. In most cases, inflammation occurs due to the penetration of viruses and infections, but there are other causes.
Most often, this disease appears with the onset of cold weather in autumn-winter, as well as in the summer, when the swimming season was open. Often, while swimming in lakes and ponds, water gets into a person’s ears, which causes the development of otitis media.
What is it?
Otitis externa is an inflammatory disease of the external auditory canal. This pathology occurs in people of all age groups, but children are most susceptible to it. Most often, the disease is a consequence of inaccurate removal of ear secretions, as well as regular entry of water into the ear canal.
Reasons
According to statistics, in approximately 5% of adults who develop otitis media, the disease becomes chronic. A climate with high humidity has a greater influence on the occurrence of this disease than a dry climate. As for children, those most susceptible to otitis are those who are twelve years of age.
Otitis is divided into limited (a purulent formation in the form of a boil is formed) and diffuse. With the second type of external otitis, the eardrum often becomes inflamed.
The most important cause of external otitis is infection of various types.
In order for the infection to enter the body, it is enough to scratch or injure the ear area a little. Also, if the ear canal is constantly moist, it can lose its protective barrier and serve as an entry point for infections.
Children suffering from eczema are very often susceptible to inflammation, due to frequent flaking in the ear. Getting rid of wax on your own also serves as a risk factor for the occurrence of such otitis media. Other causes of this disease include chronic otitis media, narrow ear canal, and diseases that are accompanied by poor immune function (for example, diabetes).
Symptoms of external otitis
It should be noted that hearing with external otitis is usually not impaired. Only in very rare cases, when very severe swelling leads to a narrowing of the ear canal, can it be reduced.
Specific symptoms of external otitis in adults:
- swelling of the skin of the ear canal;
- painful sensations when pressing on the auricle;
- the pain may also intensify when chewing, sometimes itching;
- redness of the ear canal;
- ear congestion;
- slight increase in body temperature.
In adults, external otitis is of two types: limited and diffuse. The first manifests itself in the form of inflammation of the hair follicle. And the second type is when inflammation affects the entire ear canal. With limited otitis media, a person may not even realize that he is sick, because... The main symptom here is pain that appears when talking or chewing.
Diffuse external otitis can be bacterial, fungal and allergic, and it is caused by inflammation caused by streptococci, epidermal staphylococci, Pseudomonas aeruginosa, Candida fungi, and aspergillus. Streptococci enter the body through microcracks in the skin, body temperature rises, and the ear becomes red.
Signs of external otitis in this case: pain and itching in the ear, possible purulent discharge of an unpleasant odor.
Diagnostics
The symptoms of otitis externa are obvious, so the diagnosis is quite simple. However, the diagnosis of the disease must be provided to the doctor, especially when it concerns a child, since an error in self-diagnosis leads to harmful self-medication.
A medical history and physical examination are usually sufficient to diagnose the disease. To clarify the diagnosis, otoscopy, otomicroscopy, tampanometry, acoustic reflectometry, microbiological studies and other methods can be used.
How to treat otitis externa?
Traditional treatment regimen for otitis externa in adults:
- antibiotic therapy (exclusively as prescribed by a doctor);
- compresses;
- ensuring free breathing through the nose;
- vitamin therapy to strengthen the immune system.
Using antibiotics, you can extinguish the source of the disease and gradually relieve pain. Almost all drops and ointments contain analgesic components. If you select and take antibiotics incorrectly, in some cases this can lead to side effects associated with deterioration of hearing or the general condition of the body.
In adults, special attention should be paid to hygiene procedures when treating otitis media. They must be performed exclusively according to a specific scheme. If carried out incorrectly, wax plugs can form in the ears (photo), and if you do not keep your ears dry, a humid environment can cause bacteria to multiply.
For limited otitis externa, surgical removal of the boil may be used to clean it to promote healing. The operation is performed on the 5th day, when the abscess has matured, using a scalpel in a sterile environment. The bandage that the doctor will apply must be changed every 3 hours on the first day.
If several abscesses are found, this may indicate the presence of an infection in the blood. Then it is necessary to take antibacterial agents in the form of tablets or injections.
For the diffuse form, the treatment regimen is as follows:
- taking antibiotics;
- antihistamines to relieve swelling of the ear canal;
- antifungal agents (if the ear is affected by a fungus);
- anti-inflammatory drugs (Diclofenac, Nurofen);
- a complex of vitamins to strengthen the immune system;
- drops with antibacterial components.
Physiotherapeutic methods are used as additional measures to treat otitis externa. UVR therapy – ultraviolet irradiation.
The procedure lasts 15 minutes for 10-12 days. UHF – the effect of high-frequency ultracurrents on the site of inflammation. Each procedure lasts about 10 minutes for 5-15 days. If left untreated, the infection can spread to the middle ear and cause serious complications.
Prevention
Prevention of external otitis is as follows:
- First of all, you need to properly care for your ears. You can use cotton swabs for hygiene procedures, but you can insert them into the ear canal no more than 0.5 cm. Usually it is enough to remove accumulated earwax only at the entrance to the ear canal.
- It is not recommended to remove wax plugs and foreign bodies from the ear canal yourself; it is better to entrust this procedure to a doctor.
- You should not use sharp objects to clean your ears, as they can damage the skin of the ear canal and create a so-called gateway for infection.
- It is necessary to protect your ears from water getting into them while washing or swimming, especially in open water.
View photos
A severe case of otitis externa. Deep tissue damage, narrowing of the ear canal and swelling of the auricle are visible.
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Forecast
Most often, the disease resolves without complications or difficulties. Obvious symptoms subside after 2-5 days of treatment, and after 7-10 days complete recovery occurs. To fully restore hearing, it is sometimes necessary to treat the external auditory canal by a doctor.
Complications from this disease are quite rare; these include cellulitis or facial lymphadenitis. Acute external otitis may spread to the auricle, turning into chondritis, which is especially common in patients with recent piercings.
Otitis externa– inflammation of the outer ear, consisting of the auricle, external auditory canal, and eardrum. Most often the disease is caused by bacteria, although there are other causes.
According to official statistics, acute external otitis is experienced annually by 4–5 people per 1000 people worldwide. Between 3% and 5% of people suffer from a chronic form of the disease. Otitis externa is common among residents of all countries. In warm, humid climates, the incidence is higher. People who have a narrow ear canal are more prone to otitis media.
The disease affects males and females equally often. The peak incidence occurs in children between 7 and 12 years of age. This is due to the anatomical features of the structure of the child’s ear and the imperfection of protective mechanisms.
Otitis externa is an occupational disease for divers, swimmers and other people who frequently get water into the external ear canal.
Anatomical features of the external auditory canal
The human hearing organ consists of three parts: outer, middle and inner ear.Structure of the outer ear:
- Auricle. It is cartilage covered with skin. The only part of the auricle that lacks cartilage is the lobe. In its thickness there is adipose tissue. The auricle is attached to the skull by ligaments and muscles behind the temporomandibular joint. It has a characteristic shape; at its bottom there is an opening leading to the external auditory canal. The skin around it contains many sebaceous glands; it is covered with hairs, which are especially strongly developed in older people. They perform a protective function.
- External auditory canal. Connects the external opening located in the auricle with the cavity of the middle ear (tympanic cavity). It is a canal 2.5 cm long and 0.7–1.0 cm wide. In the initial section under the canal there is the parotid salivary gland. This creates conditions for the spread of infection from the gland to the ear with mumps and from the ear to the tissue of the gland with otitis. 2/3 of the external auditory canal is located in the thickness of the temporal bone of the skull. Here the canal has its narrowest part - the isthmus. On the surface of the skin inside the passage there is a lot of hair, sebaceous and sulfur glands (which, in fact, are also modified sebaceous glands). They produce a secretion that combines with dead skin cells to form earwax. The latter helps remove pathogens and foreign bodies from the ear. Evacuation of earwax from the external auditory canal occurs during chewing of food. If this process is disrupted, then an ear plug is formed and natural protective mechanisms are disrupted.
- Eardrum separates the outer ear from the middle ear (tympanic cavity). It is involved in sound conduction, and during infection it serves as a mechanical barrier.
Features of the children's ear that increase the likelihood of developing otitis media compared to adults:
- Imperfect defense mechanisms. The child’s immunity continues to develop after birth; it cannot provide full protection.
- The child's ear has some anatomical features. The external auditory canal is shorter and looks like a slit.
- Children's ear skin is more delicate and is easier to damage when cleaning and combing the ears.
Causes of otitis externa
Classification of external otitis by origin:- Infectious – caused by pathogenic microorganisms.
- Non-infectious - caused by other reasons, for example, irritation or allergic reactions.
- Pseudomonas aeruginosa;
Improper hygiene of the outer ear:
- Lack of ear care. It is advisable to wash them daily with soap and dry with a towel. Otherwise, dirt will accumulate in them, which increases the risk of infection. For children in their first year of life, their ears are wiped with special wet wipes and cotton swabs.
- Cleaning the outer ear canals too often. Regularly cleaning your ears with a cotton swab helps remove remaining earwax and dirt. But this should not be done too often, otherwise the likelihood of developing cerumen plugs and otitis externa increases. 1 – 2 times a week is enough.
- Improper cleaning of the ear canals. Adults often do this with matches, metal objects (blunt ends of darning needles, knitting needles), and toothpicks. This leads to skin injury and infection. Pathogenic bacteria can enter the ear from objects. It is permissible to use only special cotton swabs to clean your ears. In children under one year old, ears are cleaned only with cotton wool; hard sticks cannot be used at this age.
- Ear cleaning too deep. The resulting earwax gradually moves towards the outer opening and accumulates near it in the form of a small rim. Therefore, it makes no sense to clean an adult’s ears deeper than 1 cm - this only increases the risk of infection.
Earwax formation disorder:
- Insufficient earwax production The natural protective mechanisms of the ear are reduced. After all, sulfur actively takes part in the removal of pathogens from the external ear canal.
- For excess earwax and disruption of its removal, ear cleansing is also disrupted, wax plugs form, and the risk of infection increases.
Foreign bodies and water getting into the ears:
- Foreign bodies, getting into the external auditory canal, injure the skin, cause irritation and swelling. Conditions are created for infection to enter.
- Along with water pathogenic microorganisms are introduced into the ear, creating a favorable environment for their reproduction. Earwax secretion and protection are impaired.
Decreased immunity and protective reactions:
- hypothermia, the effect of strong cold wind on the ear;
- chronic and severe diseases leading to depletion of immune forces;
- frequent infections;
- immunodeficiency states: AIDS, congenital immune defects.
Infectious diseases of neighboring organs (secondary otitis):
- Skin infections: boil, carbuncle, etc. The causative agents of the disease can enter the ear from pustules on the adjacent skin.
- Mumps- inflammation of the parotid salivary gland.
Taking certain medications:
- Immunosuppressants and cytostatics– drugs that suppress the immune system. With their long-term use, the risk of developing otitis media and other infectious diseases increases.
- Incorrect use of antibiotics over a long period of time and in high doses can lead to fungal external otitis. This applies to both injectable tablets and antibacterial creams and ointments applied to the ear area.
Dermatological diseases
At eczema and other skin diseases, the process can affect the area around the ear. In this case, the doctor can make a diagnosis of external non-infectious otitis.Manifestations of external otitis
Classification of external otitis depending on the form of the disease:- process limited in area - ear furuncle;
- widespread purulent external otitis;
- perichondritis (inflammation of the cartilage) of the auricle;
- otomycosis - fungal infection of the outer ear;
- eczema of the skin of the outer ear is the most common type of non-infectious external otitis.
- spicy;
- chronic.
Furuncle of the external auditory canal
Furuncle– purulent inflammation involving the sebaceous gland or hair follicle. It can only occur in the outer part of the ear canal, since the inner part lacks hair and sebaceous glands. Symptoms of a boil in the external auditory canal:
- Acute severe pain in the ear, which radiates to the jaw, neck, and spreads to the entire head.
- Increased pain while chewing, pulling the ear to the side or pressing in the area of the external opening of the ear canal.
- Increased body temperature– Not observed in all patients.
- General health disorder– not present in all patients; it can be expressed to varying degrees.
A furuncle of the ear can be a manifestation of a systemic disease - furunculosis. In this case, boils periodically appear on different parts of the body. Furunculosis usually develops with decreased immunity.
Diffuse external otitis
Diffuse external otitis– a purulent inflammatory process that spreads to the entire external auditory canal, involves the subcutaneous layer, and can affect the eardrum. Signs of acute diffuse external otitis:
- itching in the ear;
- pain when pressing in the area of the external opening of the auditory canal;
- swelling in the ear area, narrowing of the external opening of the auditory canal;
- discharge of pus from the ear;
- increased body temperature, general deterioration.
With external otitis, hearing is not impaired. This is its main difference from otitis media, in which the tympanic cavity is affected.
Erysipelas of the ear
Erysipelas (erysipelas)– a special type of bacterial otitis caused by streptococcal bacteria. Manifestations of erysipelas:
- severe pain, itching in the ear;
- swelling of the skin in the area of the auricle;
- redness of the skin: it has clear contours, often involving the lobe;
- increased skin temperature in the area of inflammation;
- the formation of bubbles with transparent contents on the skin - observed only in isolated cases;
- increase in body temperature to 39 – 40 ⁰C;
- chills, headache, general malaise.
There are periods of improvement, followed by new relapses.
Otomycoses
Otomycoses– inflammatory diseases of the ears caused by fungi, most often belonging to the genus Aspergillus or Candida. Often during external otitis, a combination of fungi and bacteria is detected, for example, Candida and Staphylococcus aureus. Signs of fungal infection of the outer ear:
- All symptoms increase gradually as the fungus grows into the skin and toxins accumulate.
- Itching and pain in the ear. The patient may feel as if there is a foreign body in the outer ear canal.
- Feeling stuffed up.
- Headaches on the affected side.
- Films and crusts on the skin of the auricle are usually formed when affected by fungi of the genus Candida.
- Discharge from the ears varies in color and consistency, depending on the type of fungus.
Perichondritis of the auricle
Perichondritis of the auricle- a type of external otitis that affects perichondrium(the shell of the ear cartilage) and the skin of the ear. Typically, the cause of perichondritis is an ear injury followed by an infection. Symptoms:
- Pain in the ear or external auditory canal.
- Swelling of the ear. It spreads throughout the earlobe, including the earlobe.
- Accumulation of pus in the ear. During palpation, a cavity with liquid is felt. Usually this symptom occurs after a few days, when the ear tissue melts.
- Increasing pain. Touching the ear becomes very painful.
- Increased body temperature, general malaise.
Diagnosis of external otitis
The diagnosis and treatment of external otitis is carried out by an otolaryngologist (ENT doctor). First, the doctor examines the skin in the ear area, presses in different places, and checks for pain.Studies and tests that a doctor may prescribe if otitis externa is suspected
| Study title | Description of what it detects | How is it carried out? |
| General blood test | A general blood test is a test that is prescribed for most diseases. It helps to identify the presence of inflammation in the body. This is evidenced by an increase in the number of leukocytes and some other indicators. | Blood is drawn from a finger, usually done in the morning. |
| Otoscopy | Examination of the external auditory canal, during which the doctor evaluates its condition, as well as the appearance and condition of the eardrum. Otoscopy helps to identify swelling and other pathological changes in the wall of the ear canal and detect discharge. | Otoscopy is performed using special metal funnels that the doctor inserts into the ear. For ease of inspection, the auricle is usually slightly retracted:
 |
| Hearing test | Helps the doctor evaluate the patient's hearing. With external otitis it should be normal. At otitis media accompanied by defeat tympanic cavity, it is reduced. | The doctor asks the patient to move 5 meters away (to the opposite corner of the office) and cover one ear with his palm. He pronounces phrases in a whisper, the patient must repeat them. Then the function of the second ear is examined in the same way.  |
| Bacteriological examination of ear discharge | Helps identify the causative agent of the disease and prescribe the correct treatment. | Using a cotton swab, the doctor takes a small amount of discharge from the ear and sends it to the laboratory for examination under a microscope and bacteriological examination (culture). The result is usually ready within a few days.  |
Treatment of external otitis
Treatment of boils in the external auditory canal
| Preparation | Description | Directions for use |
| Oxacillin | An antibiotic effective against staphylococcal bacteria - the main causative agents of boils. | Release forms:
|
| Ampicillin | Broad-spectrum antibiotic - effective against a large number of pathogens, except for some types of staphylococci. | Release forms:
|
| Amoxicillin | Broad-spectrum antibiotic. Effective against many types of bacteria, including those that are resistant to other drugs from this group. | Release forms:
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| Cefazolin | Broad-spectrum antibacterial drug. Effective against most types of pathogenic bacteria, including staphylococci. Has no effect against bacteria and viruses. Usually used for severe ear boils. | Release forms: The drug is available in powder form for dissolution in sterile water and injection in 0.125, 0.25, 0.5, 1.0 and 2.0 g. Directions for use:
|
| Cephalexin | An antibiotic that is effective mainly against streptococci and staphylococci. It is used, as a rule, for severe ear boils. | Release forms:
|
| Augmentin (Amoxiclav) | A combined drug consisting of two components:
| Release forms:
|
| A mixture of boric alcohol (an alcohol solution of boric acid) and glycerin. | Boric alcohol has antibacterial, astringent, anti-inflammatory effects. Glycerol increases the viscosity of the solution and serves to give it the required consistency. | The composition is used as a local anti-inflammatory agent. They impregnate a cotton pad, which is placed in the external auditory canal. Boric alcohol and glycerin are mixed in different proportions. |
Antipyretic and anti-inflammatory drugs:
| These drugs are used to combat elevated body temperature and inflammation. | Prescribed in usual dosages according to indications when body temperature rises above 38⁰C, with severe pain. |
| UV therapy | A physiotherapeutic technique involving the use of ultraviolet radiation. Effects:
| Irradiation is carried out using a special device for 10 – 15 minutes. The course usually consists of 10 – 12 procedures.  |
| UHF therapy | The affected area is affected using ultra-high frequency currents. Effects:
| Electrodes are applied to the area of the pathological focus, with the help of which the effect is carried out. The duration of the procedure is on average 8 – 15 minutes. The course of treatment usually includes from 5 to 15 procedures. A repeat course can be carried out after 2 – 3 months.  |
| Opening a boil | Surgical opening of the boil is performed to clean the abscess and speed up healing. This is usually done on days 4–5, when the abscess has matured. | An ear boil is opened by a surgeon using a scalpel under sterile conditions. A bandage is applied, which must be changed every 3 to 4 hours during the first day. |
Treatment of diffuse external otitis
| Preparation | Description | Directions for use |
| Antibacterial therapy (use of antibiotics) | See “Treatment of a boil in the external auditory canal.” | |
Antipyretic and anti-inflammatory drugs:
| See “Treatment of a boil in the external auditory canal.” | See “Treatment of a boil in the external auditory canal.” |
Antiallergic drugs:
| The mechanism of development of diffuse external otitis always contains an allergic component. The patient’s immune system reacts violently to pathogen toxins and breakdown products that form in the area of inflammation. Antiallergic medications help fight symptoms that occur. | The choice of drug and dosage is made by the attending physician. |
| Rinsing the external auditory canal with furacillin solution. | Furacilin is an antiseptic that destroys pathogens. In addition, a stream of solution washes away pus and accumulated wax from the ear. The prepared solution of furatsilin is sold in glass bottles. | Carrying out the procedure:
|
| Autohemotherapy | Treatment of the patient with his own blood. It is performed for severe diffuse external otitis and furunculosis. | 4–10 ml of blood is taken from the patient’s vein using a syringe, which is injected intramuscularly. The procedure is repeated every 48 hours. This helps to enhance defense mechanisms. |
| UHF, microwave | See “Treatment of a boil in the external auditory canal.” | See “Treatment of a boil in the external auditory canal.” |
What drops are prescribed for otitis externa?
| Name of drops | Mechanism of action | Directions for use |
| Anauran | The effect is ensured by three active components included in the drug:
| Anauran instilled into the affected ear using a special pipette. They tilt their head and try to keep it in the external auditory canal for as long as possible. Dosages:
|
| Garazon | The effect is due to the action of two active components included in the drug:
| Directions for use:
|
| Otinum | The active ingredient in this drug is cholim salicylate. It has anti-inflammatory and analgesic effects. | Instill 3–4 drops of the drug into the affected ear 3–4 times a day. Instillation is carried out in a lying position, so that the sore ear is on top. After this, you need to lie on your side for a little longer so that the drug does not leak out and has time to act. |
| Otipax | The drug contains two active ingredients:
| Instill 4 drops of the drug into the sore ear 2 – 3 times a day. The course of treatment can be continued for no more than 10 days. |
| Otofa | Drops contain antibiotic rifampicin, which destroys streptococci and staphylococci. It is highly effective, but in some cases can cause allergic reactions. |
|
| Polydexa | The effect of the drops is due to the active components that are included in their composition:
| Instill 1–5 drops of the drug into the ear affected by otitis media 2 times a day. The course of treatment is continued for 6–10 days, no more. |
| Sofradex | The drug contains three active components that determine its effects:
| Instill 2-3 drops of the drug into the affected ear 3-4 times a day. |
How to properly instill ear drops?
- The ear must first be thoroughly cleaned using cotton swabs.
- The patient is placed on his side so that the affected ear is on top.
- Before use, the bottle with the solution must be heated. To do this, just hold it in a warm hand for a while.
- Instillation is carried out using a pipette (a special pipette may be included with the drops).
- In order for the external auditory canal to straighten and the drops to easily penetrate into it, you need to pull the auricle up and back (in children - down and back).
- After instillation, you need to lie on your side for a little longer so that the drops linger in the ear and take effect.
Treatment of erysipelas of the ear
- The patient must be isolated from healthy people to prevent the spread of infection.
- Antibacterial therapy is carried out, as for ear boils and diffuse external otitis.
- Treatment with antibiotics is supplemented with antiallergic drugs, as with diffuse external otitis.
- Vitamin complexes and adaptogens (aloe extract, ginseng root, Schisandra chinensis, etc.) are prescribed.
- Physiotherapy includes ultraviolet irradiation of the affected area.
Treatment of otomycosis
| Preparation | Description | Directions for use |
| Otomycoses caused by Aspergillus fungi | ||
| Nitrofungin (Nihlofen, Nichlorgin) | The solution is yellow. This medicine is used to treat fungal skin lesions in various areas. | Lubricate the affected areas of the skin with the solution 2 – 3 times a day. Insert a piece of cotton wool soaked in the solution into the external auditory canal. The solution is sold in pharmacies in bottles of 25, 30 and 50 ml. |
| Apply the drug solution to the affected areas twice a day or insert a moistened piece of cotton wool into the external auditory canal. The solution is sold in pharmacies in 10 ml bottles. |
|
| Lamisil (Terbinafine, Terbinox, Termicon, Exifin) | A broad-spectrum antifungal drug – effective against a large number of types of pathogens. Penetrates the skin very quickly and has an effect. | The drug can be used topically in three forms:
|
| Otomycoses caused by Candida fungi | ||
| Clotrimazole (Vikaderm, Antifungol, Candide, Candibene, Clofan, Clomazole) | An antifungal drug that has a broad spectrum of action and is effective against many types of fungi. For local use only. | Clotrimazole is available in the form of ointment, cream, lotion and aerosol. These products are applied in small quantities to the skin 2 – 3 times a day. The duration of treatment is from 1 to 4 weeks. |
| Nizoral (Ketoconazole, Mycozoral, Oronazole) | A drug similar in properties to clotrimazole. | Available in the form of cream and ointment. Apply to the affected area in a small amount 2 times a day. |
| Mycozolon | Combined drug. Compound:
| The drug is an ointment that is applied to the affected area 1 – 2 times a day. |
| Pimafucin (Natamycin) | An antibiotic effective against fungi and other pathogens. | For otitis, it is used in the form of a cream, which is applied 1 - 2 times a day for 10 - 14 days. |
| Otitis externa caused by a combination of fungi and bacteria | ||
| Exoderil (Naftifin, Fetimin) | Effects:
| The drug is available in the form of a cream and solution for external use. Apply to skin once a day. The course of treatment is from 2 to 6 weeks, depending on the type of pathogen and the severity of the disease. |
| Batrafen (Ciclopirox, Dafnegin) | The drug is active against fungi and certain types of bacteria. | Available in the form of solution and cream. The drug is applied to the affected area 2 times a day. The average duration of treatment is 2 weeks. |
| Systemic drugs used for severe forms of mycoses | ||
| Fluconazole (Diflucan, Medoflucan, Diflazon) | A modern antifungal drug that has a pronounced effect against different types of fungi. | Release forms:
|
| Itraconazole (Orungal, Kanazol, Sporanox) | A broad-spectrum drug. Effective against most types of pathogenic fungi. | Release forms:
Adults take 0.1 - 0.2 g of the drug daily. Duration of treatment – 1 – 2 weeks. |
| Ketoconazole | See above | Orally, systemically, the drug is taken in the form of tablets of 0.2 g. Take 1 tablet 1 time per day before meals. Duration of treatment – 2 – 8 weeks. |
| Other drugs | ||
| Boric acid | Available in the form of solutions of 3%, 2%, 1% and 0.5%. To treat otitis externa, a cotton swab soaked in a solution of boric acid is inserted into the ear. |
|
| Silver nitrate (silver nitrate) | It is an antiseptic and disinfectant. | In otolaryngology it is used in the form of a 30% - 50% solution. The product is carefully applied to the affected area by a doctor using a probe, so that silver nitrate does not get on healthy skin. The procedure is performed once every 3 days. |
Treatment of perichondritis of the auricle
- Antibiotic therapy. For perichondritis of the auricle, the same groups of antibacterial drugs are prescribed as for ear furuncle and diffuse external otitis.
- Physiotherapy: ultraviolet irradiation, UHF therapy.
- Opening an abscess. If a cavity with liquid pus is felt under the skin, then surgical treatment is performed: the doctor makes an incision, releases the pus and applies a bandage with an antiseptic or antibiotic. Dressings are done daily until complete healing.
Features of the treatment of external otitis in children
- If signs of illness appear in a child, especially younger ones, you should immediately show him to a doctor. Children have imperfect defense mechanisms. Incorrect treatment or lack thereof can lead to serious complications.
- In general, the same drugs are used in childhood as in adults. But some medications are contraindicated in certain age groups, you need to remember this.
- When instilling drops into a child’s ear, the pinna should be pulled not up and back, as in adults, but down and back.
- Often otitis in children occurs against the background of colds, adenoiditis(inflammation adenoids– palatine tonsils). These conditions also need treatment.
Folk remedies for treating otitis
Turunda with propolis
You need to take a small piece of cotton wool, soak it in propolis and place it in your ear. Walk like this throughout the day. Propolis is an antiseptic and contains biologically active substances that restore protective mechanisms.
Turunda with onion juice
Soak a cotton swab in onion juice. The juice must be freshly squeezed, otherwise it will lose its quality and turn into a breeding ground for pathogens. Onion juice contains phytoncides - powerful natural antiseptics.
Turunda with vegetable oil
Heat some vegetable oil (sunflower or olive) in a water bath. Cool to room temperature. Soak a small piece of cotton wool in the oil and place it in the outer ear canal overnight.
Geranium leaf
This herbal remedy will help relieve pain and other unpleasant symptoms. Wash the geranium leaf thoroughly, dry it, then crumple it and place it in the outer ear canal. Do not take a leaf that is too large and place it too deep in the ear.
Drops from chamomile infusion
You can collect and dry chamomile flowers yourself, or you can buy ready-made raw materials at the pharmacy. You need to take a teaspoon of the dried plant and pour a glass of boiling water. Leave for 15 minutes. Strain. Cool. Instill 2–3 drops 3–4 times a day.
Otitis externa is a disease of predominantly infectious etiology, in which the skin of the auricle and external auditory canal becomes inflamed. Men and women get sick equally often. The highest incidence rate is observed in children 7-12 years old, which is associated with the immaturity of protective mechanisms and frequent colds.
Damage to the auricle and external auditory tube often occurs as a boil (pyoderma) and has an infectious etiology. Untimely or incorrect therapy is fraught with the spread of the inflammatory process, damage to the middle ear and other consequences.
Types of external otitis
Inflammation can be right-sided, left-sided and bilateral. There are focal and. In the first case, a small area is affected, and in the second, the entire outer ear is affected. Specific types of the disease include:
- otomycosis (fungal infection);
- perichondritis (characterized by involvement of the skin and perichondrium).
Inflammation is caused by infection and mechanical damage to tissue. Often there is a combined lesion of the internal and middle parts of the hearing organ.
Limited
The limited (focal) form of the disease occurs like a boil. There are 3 stages: infiltration, suppuration (tissue necrosis) and healing. Initially, there is an area of redness and swelling in the outer ear area. Gradually, the boil increases in size to 1-3 cm. It thickens. Already at an early stage, compression of the nerves is possible.
After 3-4 days, pus begins to accumulate. A necrotic core is formed. The abscess protrudes outward in the form of a pustule. After some time, pus is released, after which pain and other symptoms decrease. In the next stage, the tissue heals to form a scar. Often multiple secondary ulcers form in the area of the outer ear. The reason is the spread of germs.
Spicy
Acute inflammation is characterized by a rapid course and sudden onset. A characteristic sign of the disease is the presence of symptoms of intoxication (fever, chills, weakness) and intense pain. Inflammation of the ear canal lasts 1-2 weeks and most often ends safely.
Fungal
This form of otitis is caused by microscopic fungi of the Aspergillus and Candida species. A mixed infection (bacterial-fungal) is possible. A specific sign of otomycosis caused by Candida fungi is the presence of a white coating on the skin in the form of a film or crust.
Purulent
The presence of pus in the ear indicates the uncontrolled proliferation of bacteria (staphylococci, streptococci). In the presence of provoking factors (water getting into the ear, decreased immunity, use of headphones), the number of microbes increases sharply. They begin to show their pathogenic properties. most often occurs in an acute form.
Malignant
In some people, the disease occurs in a malignant form. The causative agent is Pseudomonas aeruginosa. With this form of the disease, there is a danger for patients due to the risk of developing osteomyelitis of the bones of the skull base and hearing loss. The risk group includes frail and elderly people, patients with HIV infection and diabetes.
Chronic
This form of otitis is characterized by a long course with periodic exacerbations (4 times a year or more often). Clinical signs are mild. With this pathology, complaints persist for more than 2 months.
Diffuse
With diffuse damage to the external organ of hearing in children and adults, diffuse tissue inflammation is observed, involving bone and cartilage.
Causes of external otitis
Inflammation of the ear inside and outside the canal, as well as the auricle, is caused by infectious and other causes. In the first case, the disease is caused by pathogenic microbes (usually bacteria), and in the second - by external and internal factors.
Improper hygiene of the outer ear
Often the person himself is to blame for the occurrence of otitis media. The causes of the disease are:
- Failure to comply with simple rules of personal hygiene (rarely washing ears). It is recommended to wash your ears every day with soap or shower gel. After water procedures, you need to wipe your ears dry. Water penetration can cause inflammation. To avoid otitis, young children's ears are wiped with swabs and special cotton swabs.
- Irrational cleaning of ears from wax. Daily use of cotton swabs contributes to the formation of wax plugs and inflammation. It is recommended to clean your ears 1-2 times a week.
- Injury to the outer ear during cleaning. Inflammation often develops when hard and sharp objects (matches, toothpicks, knitting needles) are used to cleanse the hearing organ. This reduces the skin's barrier function and promotes bacterial growth. In addition, non-sterile objects themselves can be a factor in the transmission of germs.
- Cleaning too deep. It is not recommended to insert cotton swabs deeper than 1-1.5 cm.
Earwax formation disorder
The cause of the disease is the excessive formation of sulfur or its insufficient release.
Foreign bodies and water getting into the ears
The inflammatory process is often caused by various objects getting into the ear. These can be buttons, toy parts and insects. They injure and irritate the skin, promoting the inflammatory process. The protective function is reduced when water gets into the ear while swimming.
Water from dirty reservoirs is especially dangerous.
Decreased immunity and defense reactions
The risk group includes people with reduced resistance to infections. This is possible in the later stages of HIV infection, with pulmonary tuberculosis, decompensated diabetes mellitus, cancer, after chemotherapy and radiation, with blood diseases, chronic fatigue syndrome, hypovitaminosis, cachexia (exhaustion) and frequent infectious diseases. The triggering factor may be hypothermia.
Infectious diseases of neighboring organs: secondary otitis
The development of secondary otitis can lead to:
- mumps (an inflammatory disease characterized by damage to the salivary glands);
- diabetes mellitus;
- labyrinthitis;
- tonsillitis;
- angina;
- syphilis;
- tuberculosis.
Taking certain medications
The likelihood of ear inflammation increases when taking ototoxic drugs (aminoglycosides), antimicrobial agents (Furadonin), contraceptives, cytostatics, Aspirin and anti-tuberculosis drugs. This pathology often develops against the background of uncontrolled use of antiseptics and drops.
Dermatological diseases
Pyoderma (pustular skin diseases) can lead to otitis media. These include furuncle, furunculosis and carbuncle. A common cause of ear inflammation is skin diseases accompanied by intense itching (eczema, allergic dermatitis, urticaria).
Symptoms of external otitis
Symptoms of the disease are:
- Pain. With limited inflammation, it is intense, radiating to the jaw, head and neck. The pain intensifies when eating food, pressing on the ear canal, pulling the ear and at night.
- Pain on palpation. It is most pronounced with a boil.
- Intense itching. Observed with diffuse inflammation.
- Swelling of tissues. In the purulent form of the disease, the ear swells greatly.
- High temperature. It does not occur in all patients.
- Deterioration in general health.
- Purulent discharge. With a boil, after the pus has drained and the abscess has broken through, the symptoms decrease.
- Presence of pustules (with limited otitis media). They are 1-2 cm in size and round in shape.
- Discomfort in the ear area.
- White plaque (at ).
- Hearing loss (decreased hearing acuity). The reason is the blocking of the lumen of the external auditory canal.
- Presence of infiltration (compaction).
- Decreased appetite.
- Enlarged lymph nodes located near the hearing organ. This symptom is observed with limited damage to the ear with multiple ulcers.
The acute form of the disease lasts 2-3 weeks. When the ear is inflamed against the background of erysipelas, the following are observed: redness of the skin in the ear area, fever up to 40 ºC, chills, dry mouth, pain in the muscles and joints, swelling of the tissues in the area where the salivary glands are located. When the ear is affected due to mycosis, tinnitus, headache, itching, congestion and otorrhea (discharge from the ears) are noted.
In adults
In adults, this pathology has a long course and is characterized by scanty symptoms. During the remission phase, pain is often absent. Possible discomfort.
In children
Inflammation of the outer ear in children is possible against the background of otitis media due to the spread of pus during perforation of the eardrum. The course of otitis media can be acute, chronic and recurrent. The disease in children is often complicated by labyrinthitis, perforation of the eardrum and meningitis (damage to the meninges).
Treatment
The treatment regimen is selected after a comprehensive examination. Diagnostics includes a survey, examination (otoscopy), physical examination, general blood test and bacteriological analysis of discharge. Treatment methods for limited otitis of the boil type are:
- Use of medications (antibiotic solutions, anti-inflammatory and antipyretic drugs). It is possible to use creams and gels. An ointment based on an anti-inflammatory agent is effective.
- Physiotherapy (UHF therapy). Inflamed tissues are exposed to ultra-high frequency current. The procedure lasts about 10 minutes.
- Surgical intervention. It is used if the abscess does not open on its own. The procedure involves cleansing the boil and sanitizing the tissue. After removing the pus, a sterile bandage with an antibiotic is applied. It needs to be changed every 3-4 hours.
- Application of "Anatoxin" or vaccine. Effective for otitis of staphylococcal nature.
Additionally, multivitamins, autohemotherapy and immunostimulating drugs are used. Diffuse otitis media can be quickly cured with antibacterial medications and antihistamines. For this pathology, ear rinsing with antiseptic solutions and physiotherapy are widely used.
Medication
For external otitis, the following medications may be prescribed:
- Systemic antibiotics (penicillins, cephalosporins, Levomycetin, tetracyclines). They are used in the form of tablets, capsules, granules, powder for oral administration or administered by injection (intramuscular, intravenous). They are prescribed taking into account the pathogen.
- Antimicrobial ointments and gels (Tetracycline, Ichthyol, Levomekol, Dimexide).
- Proteolytic enzymes (“Trypsin”). Indicated for limited otitis media to accelerate the removal of the purulent-necrotic core.
- Healing agents (“Methyluracil”).
- Hypertonic sodium chloride solution.
- Antipyretics (Panadol, Efferalgan, Ibuprofen).
- Disinfectants (boric alcohol) in combination with glycerin.
- Antiallergic drugs (Zodak, Telfast, Suprastin, Zyrtec). Helps cope with itching in the ear.
- Drops in the ears (Sofradex, Otofa, Polidexa with phenylephrine, Otipax, Otinum, Anauran). These medications are indicated for acute and chronic inflammation. Before using them, you must first clean your ear with a cotton swab or swab. The patient should be in a lateral decubitus position. The bottle with the solution must be warmed to room temperature. Pipettes are used to instill the medicine.
- Antifungal agents (“Nitrofungin”, “Clotrimazole”, “Candide”, “Imidil”, “Nichlorgin”, “Termikon”, “Terbinafine”, “Lamisil”, “Exiter”, “Binafin”, “Mikozoral”, “Funginok” , "Naftifin", "Diflucan" and "Orungal"). These drugs are indicated for otomycosis.
- Immunostimulants. These medications are effective for frequent boils and furunculosis. Immunostimulants include Polyoxidonium, Galavit and Likopid.
Folk remedies
Otitis media can be treated with folk remedies after consultation with a doctor. If the skin of the outer ear is affected, the following can be used:
- vegetable oil (they moisten a turunda or cotton wool with it and inject it into the affected ear);
- onion juice (used to lubricate inflamed skin);
- geranium leaves;
- infusion of pharmaceutical chamomile (used in the form of drops);
- bee products (propolis).
An important aspect of home therapy for limited otitis media of the furunculosis type is proper nutrition.
Patients need to exclude from the menu foods rich in simple carbohydrates and fats, pickles, smoked foods and spicy foods. It is recommended to eat fresh fruits, vegetables, berries, soups, cereals and dairy products.
What complications may arise?
The consequences of the disease can be:
- Development of otitis media. This is fraught with damage to the eardrum, mastoiditis (damage to the mastoid process), hearing loss, scarring of the membrane, neuritis of the facial nerve, inflammation of the brain, thrombosis, abscess formation, petrositis (inflammation of the petrous part of the temporal bone) and sepsis.
- Damage to the bony labyrinth located in the inner ear.
- Balance imbalance.
- Progressive hearing loss.
Preventive measures
To reduce the risk of developing otitis media, you should adhere to the following recommendations:
- wash your ears daily and dry them with a towel;
- prevent water and solid objects from entering the ear canal;
- do not use sharp objects to remove earwax;
- promptly treat skin diseases;
- do not overcool;
- wear a hat in cold and windy weather;
- prevent ear injuries;
- use special devices with a soft base to clean your ears;
- maintain immunity at a high level;
- eat well;
- promptly treat existing diseases of the ENT organs;
- stop taking ototoxic medications;
- lead a healthy lifestyle;
- Avoid listening to music on headphones for long periods of time (this promotes the growth of germs).
In order to prevent complications, you need to consult a doctor in a timely manner, adhere to his recommendations for treating the disease and refrain from self-medication.
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Otitis externa is a disease accompanied by inflammation in the outer ear.
Turning to medical statistics, it turns out that otitis externa is more common in people living in warm climates. It is also known that the disease becomes chronic in only 3-5% of patients. Children are susceptible to ear infections between the ages of 7 and 12 years.
Otitis externa is also called “a disease of divers and swimmers” because fluid regularly penetrates into the ear canals of these people.
In medicine, there are 2 types of disease:
- limited type - (presented in the form of inflammation of the hair follicle - boil);
- diffuse type - (during the disease, the area of the entire ear canal becomes inflamed).
The main cause of otitis externa is infection. The culprit in this case is a bacterium, which causes a boil to form in the area of the ear canal. The next cause of the development of the disease is the Candida fungus.
Bacteria and infections enter through abrasions and wounds. This environment is ideal for their reproduction and life. Bacteria can also “make their way” through the damp ear canal, which in this state loses its protective functions.
The reasons for the development of otitis include the presence of sulfur plugs, which many try to eliminate on their own. Such a rash act leads to complications in the form of otitis media.
Secondary causes of the disease may be:
- otitis media of a chronic nature;
- diseases that are accompanied by a decrease in the body’s protective functions;
- the passage is too narrow.
Symptoms of inflammation of the outer ear are considered to be:
- burning and itching in the ear;
- gradually increasing pain;
- partial hearing loss;
- when touching the auricle, a sharp unbearable pain is felt;
- the lymph nodes in the ear area become inflamed;
- discharge of purulent fluid.
Symptoms for limited inflammation of the outer ear:
- when touched and pressed, pain in the ear increases;
- swelling;
- pain that worsens when chewing;
- redness.
Ear suppositories for otitis media can damage the skin of the ear. Therefore, doctors do not recommend using them.
Ointments to combat otitis externa
Otitis ointment is considered effective and most used for this disease. The drugs are easy to use and have virtually no contraindications or side effects.
"Sofradex". Eliminates inflammatory processes, destroys bacteria and viruses, and has an antiallergic effect.
Levomekol. Levomekol ointment for otitis has also proven itself well. The drug includes methyluracil salt (responsible for tissue regeneration, fights viruses and infections), ethylene glycol (provides absorption properties) and chloramphenicol (an antibiotic that kills pathogenic bacteria).
Levomekol is placed in the ear for otitis every day. The course of treatment is 7-11 days. The product is applied to the turunda and placed in the ear canal for 11-14 hours.
Vishnevsky ointment is also actively used for ear otitis. The medicine is intended to eliminate pain and inflammatory processes. The ointment is placed in the ear using a cotton swab for 2-3 hours.
Tetracycline ointment for otitis externa is used to heal inflammatory areas and destroy bacteria.
Risk factors for the disease
If inflammation of the outer ear is not treated in time, it can lead to:
- to the transition of the disease to a chronic form with subsequent relapses;
- infectious damage to the external auditory canal, lymph nodes, cartilage, auricle;
- mastoiditis, thrombosis, meningitis, osteomyelitis, cranial nerve palsy.
To avoid the occurrence of otitis externa, you must:
- stop using cotton swabs, matches, etc. for cleaning (it is enough to rinse the ear canals daily with your little finger);
- after swimming in a pool, lake, or sea, rinse your ear with clean water;
- Before visiting the pool, put a protective cap on your head;
- dry your hearing organs with a towel rather than cotton swabs;
- strengthen the body's protective functions;
- At the first symptoms of otitis, consult a doctor.
