External Otitis - Inflammation Of The Ear Canal

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External Otitis - Inflammation Of The Ear Canal
External Otitis - Inflammation Of The Ear Canal
Video: External Otitis - Inflammation Of The Ear Canal
Video: Swimmer’s Ear (Otitis Externa) | Risk Factors, Causes, Signs & Symptoms, Diagnosis, Treatment 2023, February
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External otitis (inflammation of the ear canal)

Various inflammations of the outer ear, more precisely the external auditory canal, are referred to as otitis externa. A distinction is made between otitis externa diffusa, otitis externa circumscripta (the so-called auditory canal furuncles) and otitis externa maligna or necrotizing otitis (this is a particularly severe form).

The inflammation is caused by infections, which in turn can come from improper cleaning and germ-contaminated water. Skin problems such as dry skin, eczema or local allergic reactions (cosmetics, care products, etc.) can encourage the entry of bacteria. The outer part of the external ear canal may be swollen shut. Lymph node swellings in the area of ​​the ear can occur with inflammation.

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  • Cleaning the ears
  • Whom can I ask?
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Otitis externa diffusa ("bath otitis")

Otitis externa is favored by injuries or cracked skin of the external auditory canal. Especially germ-contaminated water under warm conditions leads to infections (the so-called "bath otitis"). Therefore, in our latitudes, these inflammations mainly occur in summer. It can show:

  • Strong diffuse pain, especially when pressure is applied to the ear,
  • Redness, swelling of the ear canal,
  • Fever is possible
  • Secretion from the ear canal,
  • subjective hearing loss.

With diabetes mellitus (diabetes) it is easier for germs to colonize the ear canal. Very difficult courses are also possible.

How is the diagnosis made?

Symptoms (see above) and a medical examination are important for the diagnosis.

To do this, the doctor carefully cleans the ear and examines the ear canal including the middle ear. To do this, she / he uses an otoscope or microscope. A funnel is inserted into the ear canal. Using a light and a magnifying glass, the doctor can take a closer look at the external auditory canal and the middle ear. Various further examinations may be necessary, e.g. to clarify an allergy to care products, washing substances, etc.

How is the treatment carried out?

The therapy is based on the respective individual prerequisites, the characteristics and the pathogen involved. In addition to the professional rinsing or cleaning of the ear canal, drops or ointments are used which, depending on the severity and pathogen, contain cortisone, are antibiotic (with bacterial involvement) or antimycotic (effective against fungi). It may be necessary to take antibiotics. In addition, any underlying disease is treated.

Note External otitis can also be chronic. Chronic otitis media, improper cleaning of the ear canal with cotton swabs or chronic infections can be reasons for this.

External otitis circumsripta (ear canal furuncles)

Inflammation also occurs with an ear canal furuncle. In the outer part of the ear canal there is skin and hair. In the area between the hair and skin, there is a purulent inflammation (follicle, hair follicle). This can be promoted, for example, by scratching or injuries caused by improper cleaning of the ear canal. Certain bacteria (staphylococci) are usually the cause. The infection shows up among other things by

  • Severe localized pain,
  • Reddening of the skin,
  • Swelling.

If the ulcer tears, secretion comes out of the ear, which can smell unpleasant and looks creamy.

How is the diagnosis made?

Symptoms and a medical examination are important for the diagnosis. To do this, the doctor carefully cleans the ear and examines the ear canal including the middle ear. To do this, she / he uses an otoscope or microscope. A funnel is inserted into the ear canal. Using a light and a magnifying glass, the doctor can take a closer look at the external auditory canal and the middle ear. Various further examinations may be necessary, e.g. to clarify an allergy to care products, washing substances, etc. Recurring boils can be related to diabetes.

How is the treatment carried out?

The furuncle is treated by cleaning and disinfecting the external auditory canal. Topically applied antibiotics and cortisone in the form of ointments and alcohol strips are used to treat swelling and infection. Sometimes the abscess is opened (stab incision). In severe cases, further measures can be taken, e.g. taking antibiotics. Pain relievers may be necessary.

Malignant otitis externa

In malignant otitis externa (invasive or necrotic otitis externa), the inflammation spreads. This slowly spreads from the ear canal to the bones and can reach the base of the skull and cranial nerves. Serious consequences can be meningitis, skull base osteomyelitis (inflammation of the bone marrow of the skull base), brain abscess (pus in the brain) and thrombosis of certain veins in the brain (sigmoid sinus). Particularly affected are people with weakened or reduced body defenses, eg patients of old age who have been suffering from diabetes for many years and people with immunosuppression. Symptoms include:

  • Pain,
  • fetid (malodorous) secretion from the external ear canal,
  • Pus,
  • Redness,
  • Facial nerve palsy (facial nerve paralysis) and failure of other cranial nerves.

In addition, a poor general condition can show. If left untreated, malignant otitis externa is fatal.

How is the diagnosis made?

Symptoms and illnesses provide the doctor with information. In addition to examining the ear with an otoscope, CT is performed to determine the extent or spread of the disease. Laboratory values ​​can be collected and a smear can be taken and examined in order to identify the pathogen. MRI and bone scintigrams may also be necessary.

How is the treatment carried out?

Otitis externa maligna is a threatening form of the ear infection and can be treated as an inpatient. Systemic antibiotic therapy in high dosages is carried out. The best possible treatment of the underlying disease is also important. Surgery can also be done as surgical cleansing of the inflammation can be the only salvation.

Note In the event of severe pain, neurological deficits, e.g. (facial) paralysis, clouding of consciousness, seizures, loss of consciousness, etc., call the emergency doctor immediately (144)!

Cleaning the ears

Ear wax (cerumen) fulfills important functions. Among other things, it is used to clean the external auditory canal. If ear wax leaks from the external ear canal, it can be removed after washing. However, cotton swabs or other, possibly pointed objects should not be used for this. This also applies to the use of ear candles. The outside of the ear should be cleaned with a clean fingertip, maximum with a dry, clean cloth. Nothing should be introduced into the ear canal to avoid damaging the ear canal and preventing the cerumen from being pushed further into the ear canal.

The use of various objects can lead to injuries and inflammations (e.g. of the external ear canal, eardrum). Ear wax can also be pushed inside the ear and dried-on ear wax can form a solid plug. The outer area of ​​the ear can be carefully wiped with a soft cloth (washcloth, cosmetic tissue) (auricle). If the ear is regularly blocked, the ear canal should be cleaned professionally by an ENT specialist.

Whom can I ask?

Contact persons are

  • the specialist in ear, nose and throat medicine,
  • The family doctor can also be contacted and, if necessary, initiate referrals (e.g. for further examinations),
  • Specialists in paediatrics and adolescent medicine can be contacted for children,
  • other specialists can be involved.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

  • Right to treatment
  • Visit to the doctor: costs and deductibles
  • What does the hospital stay cost?
  • Prescription fee: This is how drug costs are covered
  • Rehabilitation & cure
  • Medical aids & aids
  • Health Professions AZ

and via the online guide to reimbursement of social insurance costs.

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