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Otitis Externa: Follow-up
Updated: Nov 30, 2007
Follow-up
Further Outpatient Care
Follow-up is important in order to ascertain the patient's response to treatment for otitis externa. Even in mild cases, the patient should be reassessed 2-3 days following the initiation of treatment.
Deterrence/Prevention
- Several measures that are related to ear hygiene may be taken to help prevent recurrent otitis externa infections.
- Eliminate any self-inflicted trauma to the ear canal, such as using cotton swabs or inserting objects into the external auditory canal.
- Avoid frequent washing of the ears with soap, as this leaves an alkali residue that neutralizes the acidic pH of the ear canal.
- Avoid swimming in polluted waters.
- Ensure that the ear canals are emptied of water after swimming or bathing.
- Prophylactic ear drops: A combination of a 2:1 ratio of 70% isopropyl alcohol and acetic acid may be used after each episode of swimming to assist in drying and acidifying the ear canal.
- Generally, earplugs should be avoided due to the fact that these objects may cause trauma to the ear canal, thereby predisposing to the development of otitis externa.
Complications
- Complications of otitis externa include local purulent extension of disease, such as the following:
- Necrotizing otitis externa
- Mastoiditis
- Chondritis of the auricle
- Bony erosion of the base of the skull
- Central nervous system (CNS) infection
Prognosis
- The patient may return to aquatic activities once the infection has been eradicated, generally within 4-5 days.
- Aquatic athletes may return to the pool earlier than 4-5 days; however, they need to keep their ear canals dry. Generally, after 2-3 days of refraining from any water activity, the athlete can return to water activities but the head should be kept dry until the infection has been eradicated.
Patient Education
- Otitis externa is a common problem with risk factors that can be easily avoided. Prevention of this common medical condition for aquatic athletes is the most important advancement in the past decade. When otitis externa does strike, the condition can usually be resolved in a short time with few complications.
Miscellaneous
Medicolegal Pitfalls
- Failure to recognize and appropriately treat the complications of otitis externa is the most significant medical/legal pitfall.
More on Otitis Externa |
| Overview: Otitis Externa |
| Differential Diagnoses & Workup: Otitis Externa |
| Treatment & Medication: Otitis Externa |
Follow-up: Otitis Externa |
| References |
| « Previous Page |
References
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Rosen P, Barkin RM, Hayden SR, Schaider JJ, Wolfe R. Otitis externa. The 5 Minute Emergency Medicine Consult. Philadelphia, Pa: Lippincott Williams & Wilkins; 1999:796-7.
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Further Reading
Keywords
swimmer's ear, acute diffuse otitis externa, acute localized otitis externa, necrotizing otitis externa, eczematous otitis externa, infection of the external auditory canal
Follow-up: Otitis Externa