Otitis Externa Questions & Answers

Updated: Mar 19, 2018
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Questions & Answers

Overview

What is otitis externa (OE)?

How is otitis externa (OE) diagnosed, and when should a consultation with a specialist be considered?

Which imaging studies are useful in the diagnosis of otitis externa (OE)?

What are the classifications of otitis externa (OE)?

What are the signs and symptoms of otitis externa (OE)?

Which lab studies are useful in the diagnosis of otitis externa (OE)?

What is primary treatment for otitis externa (OE)?

Which medications are used in the treatment of otitis externa (OE)?

When is surgery indicated in cases of otitis externa (OE), and what are the surgical options?

What causes otitis externa (OE)?

Why are aquatic athletes (eg, swimmers) prone to otitis externa (OE)?

Can otitis externa (OE) cause serious complications or morbidity?

What is the embryology and anatomy of the ear and where does otitis externa (OE) occur?

What are the subtypes of otitis externa (OE)?

What factors can contribute to the development of otitis externa (OE)?

How does moisture in the external auditory canal (EAC) cause otitis externa (OE)?

How does trauma cause otitis externa (OE)?

How does otitis externa (OE) manifest in the ear once infection is established?

What is necrotizing (malignant) otitis externa (OE) and what is the associated morality rate?

Which pathogens cause otitis externa (OE)?

What causes fungal otitis externa (OE) and how is it characterized?

Which conditions are associated with eczematoid (psoriatic) otitis externa (OE)?

What causes chronic otitis externa (OE)?

Who may be susceptible to necrotizing otitis externa (OE)?

What are the risk factors for otitis externa (OE)?

What is the incidence of otitis externa (OE) in the US?

What is the prevalence of otitis externa (OE) among different age groups?

Does otitis externa (OE) have sexual or racial predilection?

What is the prognosis for otitis externa (OE)?

What is the prognosis of untreated otitis externa (OE)?

What are the mortality rates associated with treated and untreated necrotizing otitis externa (OE), and when should this complication be suspected?

What educational information should be provided to patients with otitis externa (OE)?

Presentation

What are common complaints of a patient who presents with symptoms of otitis externa (OE)?

Which key physical findings are associated with otitis externa (OE)?

Which physical findings are associated with fungal otitis externa (OE)?

What are the physical findings of necrotizing otitis externa (OE)?

Which surrounding soft tissues and nerves may be involved in severe cases of otitis externa (OE)?

Which complications may occur with otitis externa (OE)?

DDX

Which conditions should be considered in the differential diagnoses (DDx) of otitis externa (OE)?

What is Ramsay Hunt syndrome (herpes zoster oticus) and how is it associated with otitis externa (OE)?

What is a furuncle and is it an indication of otitis externa (OE)?

What is skull base osteomyelitis and when should it be considered in the differential diagnoses of otitis externa (OE)?

When is a tissue biopsy indicated in the evaluation of otitis externa (OE)?

How is skull base osteomyelitis monitored and treated?

What causes a preauricular cysts and fistulas, and when is excision indicated?

How do first branchial cleft anomalies differ from preauricular cysts and fistulas?

What causes lacerations of the ear and how are they managed?

What allergies or sensitivities of the ear should be considered when evaluating otitis externa (OE)?

What role does cerumen impaction play in the evaluation of otitis externa (OE)?

How is debris in the external auditory canal (EAC) managed?

How do exostoses and osteomas differ and when do they require surgical treatment?

How are foreign bodies in the external auditory canal (EAC) managed, and which represents a medical emergency?

What are the characteristics of myringitis and how is it managed?

What are the differential diagnoses for Otitis Externa?

Workup

What is the role of lab studies in the workup of otitis externa (OE) and what are the histologic findings?

What role do imaging studies play in the diagnosis of otitis externa (OE), and which studies are preferred?

What is the purpose of otoscopic exam in the workup of otitis externa (OE)?

What are the different parts and functions of an otoscope?

What is the purpose of a pneumatic attachment on the diagnostic head of an otoscope?

What are the steps of otoscopy?

Treatment

What is the primary treatment of otitis externa (OE)?

Which over-the-counter analgesics and topical eardrops are used to treat otitis externa (OE)?

How is necrotizing (malignant) otitis externa (OE) treated?

How is debris in the external auditory canal (EAC) removed?

What are the signs that there is a foreign body in the ear canal, and which object must be treated as a medical emergency?

Why are astringents and acetic acid solutions no longer used to treat otitis externa (OE)?

Which combination topical preparation is no longer recommended to treat otitis externa (OE), and why?

What pharmacologic therapy is recommended for treating otitis externa (OE)?

Which topical medications are used to treat otitis externa (OE)?

Which topical medications are used to treat mild and moderate otitis externa (OE)?

Which topical agents are most effective in the treatment of otitis externa (OE)?

What are the potential adverse effects of aminoglycoside antibiotic eardrops in the treatment of otitis externa (OE)?

Can fluoroquinolones be used to safely treat otitis externa (OE)?

How are fungal infections of the ear treated?

What is an effective treatment option for noninfectious, therapy-resistant otitis externa (OE)?

What is the role of an ear wick in the treatment of otitis externa (OE)?

What pharmacologic therapy is effective for pain control in otitis externa (OE)?

When are oral antibiotics or IV antibiotics indicated for the treatment of otitis externa (OE)?

When is surgical debridement indicated in the treatment of otitis externa (OE)?

What is the treatment strategy for an abscess in the ear canal that develops as a complication of otitis externa (OE)?

What activities should patients with otitis externa (OE) avoid?

What recommendations can be made to help prevent recurrent otitis externa (OE)?

When is a consultation with a specialist indicated in the treatment of otitis externa (OE)?

What follow-up is advisable in the treatment of otitis externa (OE)?

Guidelines

What are the guidelines for the diagnosis and treatment of acute otitis externa (OE)?

Medications

What medications are used in the treatment of otitis externa (OE)?

Which medications in the drug class Antibiotics are used in the treatment of Otitis Externa?

Which medications in the drug class Otic, Other are used in the treatment of Otitis Externa?

Which medications in the drug class Oral Antibiotics are used in the treatment of Otitis Externa?

Which medications in the drug class Analgesics are used in the treatment of Otitis Externa?

Which medications in the drug class Antifungals, Other are used in the treatment of Otitis Externa?