External otitis: Treatment
- Laura A Goguen, MD
Laura A Goguen, MD
- Associate Professor in Otology and Laryngology
- Harvard Medical School
- Section Editors
- Daniel G Deschler, MD, FACS
Daniel G Deschler, MD, FACS
- Section Editor — Otorhinolaryngology
- Professor of Otology and Laryngology
- Harvard Medical School
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
The term "external otitis" (also known as otitis externa or swimmer's ear) refers to inflammation of the external auditory canal or auricle.
This topic will focus on the treatment of external otitis. The clinical manifestations and diagnosis of external otitis are discussed elsewhere. (See "External otitis: Pathogenesis, clinical features, and diagnosis", section on 'Diagnosis'.)
Management of most cases of external otitis involves topical drug therapy rather than oral antibiotics, as the disease is limited to the skin of the ear canal. Malignant external otitis, which refers to extension of infection to the skull base, is discussed elsewhere, as are acute otitis media and chronic suppurative otitis media with tympanic membrane perforation, which may result in ear canal inflammation. (See "Malignant (necrotizing) external otitis" and "Acute otitis media in adults", section on 'Ruptured tympanic membrane' and "Chronic suppurative otitis media (CSOM): Clinical features and diagnosis" and "Evaluation of earache in children", section on 'Traumatic tympanic membrane (TM) perforation' and "Evaluation and management of middle ear trauma".)
COMPONENTS OF CARE
The major components of managing external otitis include: cleaning the ear canal, treating inflammation and infection, and pain control.
Cleaning the ear canal — Cleaning out the external canal (aural toilet) is the first step in treatment. The removal of cerumen, desquamated skin, and purulent material from the ear canal greatly facilitates healing and enhances penetration of ear drops into the site of inflammation .
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- COMPONENTS OF CARE
- Cleaning the ear canal
- Treating inflammation and infection
- - Approach
- Mild disease
- Moderate disease
- Severe disease
- Immunocompromised hosts
- - Installation of topical agents
- - Topical preparations
- Antiseptics and acidifying solutions
- Pain control
- General counseling
- CLINICAL FOLLOW-UP
- TREATMENT OF OTHER CONDITIONS
- Contact dermatitis
- Periauricular cellulitis
- Malignant external otitis
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS