Otitis Externa Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Otitis externa is inflammation of the outer ear canal which can be caused by bacteria, allergies, or viruses. There are two types of acute otitis externa, namely:
- Otitis externa circumscripta. Circumscribed otitis externa or furuncle is an inflammation of the ear canal that occurs in 1/3 of the outer ear canal. The germs that cause it are Staphylococcus aureus or Staphylococcus albus.
- Diffuse otitis externa. If the infection affects 2/3 of the inner ear canal, it is called diffuse otitis externa. It will appear that the skin of the ear canal is reddish and swollen with no clear boundaries. The germs that cause diffuse otitis externa are usually Pseudomonas bacteria.
Symptom
There are several symptoms of otitis externa. Pain in the ear is the most commonly complained symptom. Ear pain can occur due to pressure on the tragus area of the ear.
Sufferers may also complain of a feeling of fullness in the ear, a feeling of burning pain to severe pain and throbbing. The degree of pain is more severe than the degree of infection due to swelling of the dermis in the ear canal. This swelling can press on nerve fibers resulting in intense pain.
Itching is also a very common clinical symptom and is a precursor to the pain associated with acute otitis externa. This itching can also be accompanied by a feeling of fullness and discomfort in the ear.
Edema or swelling of the skin of the ear canal and ear fluid, either sorous (clear) or purulent (thick) can cause conductive deafness and hearing loss. In addition, the skin of the ear canal/keratin that undergoes desquamation (peeling), ingress of hair, cerumen, and drugs used can cause blockage in the ear canal.
In chronic infections, you can find a foul odor with brown-gray ear discharge.
Reason
There are many causes of otitis externa. One of them is bacteria such as Staphylococcus aureus , Pseudomonas auruginosa , Haemophilus influenza , and Escherichia coli . In addition, otitis externa can be caused by various other things, such as allergies to the use of ear drops.
The older the patient, the less gram-negative microbes. Conversely, the younger the patient, the less gram-positive microbial infections. The longer the infection, the more gram-negative microbes will increase, while the gram-positive infections will decrease.
Diagnosis
The diagnosis of otitis externa can be determined from a medical interview and physical examination. Sufferers may complain of a feeling of fullness in the ear, itching, discharge in the ear, and foul-smelling ears. Other symptoms that patients may complain of are hearing loss and tinnitus.
In severe cases, the infection can spread to the tissues around the ear, including the parotid gland. Spread of infection can cause damage to nerves and bones, and can lead to more serious infections such as infections of the central nervous system.
Treatment
Treatment of otitis externa begins with topical antibiotics (drops or ointment) in the ear canal. If an abscess has formed with a collection of pus, it is necessary to make an incision or surgery to remove the pus from the ear canal.
If the dirt is not removed, then the infection will be difficult to treat. Collections of dirt or debris that have accumulated in the ear canal must be removed, so that there is direct contact between the antibiotic drug and the skin surface. Symptomatic treatment for pain relief may also be given.
Prevention
Education is an important step to prevent recurrence of external otitis or outer ear infections. Patients with a history of ear infections are advised to avoid contamination of the skin of the ear canal.
Ethyl alcohol drops (70%) or an astringent agent (aluminum acetate) can be a preventive measure in weather with high humidity. Dry skin requires moisturizing to prevent scratching and injury to the ears. For swimmers with a history of recurrent infections, the use of ear protection is recommended.