Otitis externa

Question 1

What is otitis externa?

Answer 1

An inflammatory condition affecting the external auditory canal and pinna

Question 2

What are the risk factors for OE?

Answer 2

• Water exposure
• High humidity
• Trauma to the auditory canal
• Narrow ear canals
• Immunosuppression

Question 3

What is the pathophysiology of otitis externa?

Answer 3

Bacterial: Staph A, Pseudomonas
Fungal: Aspergillus, Candida
Seborrhoeic/Contact Dermatitis

Question 4

How does OE present?

Answer 4

• Ear pain
• Ear itch
• Ear discharge
• Conductive hearing loss if becomes blocked

Question 5

What are the common otoscopy findings for OE?

Answer 5

• Red, swollen or eczematous canal
• View can be limited due to discharge/debris/swelling

Question 6

How is OE managed?

Answer 6

• Topical Abx via drops (+/- steroids)
• Removal of debris

Question 7

What is malignant otitis externa?

Answer 7

Severe and potentially life-threatening form where infection spreads to the bones around ear canal and skull -> can become osteomyelitis of temporal bone

Question 8

What is the presentation of malignant OE?

Answer 8

• Diabetic/Immunosuppresed patient
• Persistent headache
• Severe pain
• Fever
• Ear discharge/itch

Question 9

What is the key finding which indicates malignant otitis externa?

Answer 9

Graulation tissue at the junction between the bone and the cartilage

Question 10

How is MOE managed?

Answer 10

• Admission to hospital
• IV Abx
• Imaging to assess the extent of infection