Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • ear pain
  • tragal tenderness
  • ear canal swelling and erythema
  • granulation tissue in the ear canal (malignant otitis externa)

Other diagnostic factors

  • otorrhoea
  • aural fullness
  • itching
  • decreased hearing
  • erythematous tympanic membrane

Risk factors

  • external auditory canal obstruction
  • high environmental humidity
  • warmer environmental temperatures
  • swimming
  • local trauma
  • chemical irritants
  • allergy
  • skin disease
  • diabetes
  • immunocompromised
  • prolonged used of topical antibacterial agents

Diagnostic investigations

1st investigations to order

  • pneumatic otoscopy
  • tympanometry
Full details

Investigations to consider

  • ear culture
  • microscopy of exudate/debris from ear canal
  • CT scan of the temporal bone with IV contrast
  • MRI of the brain and internal auditory canals (with and without gadolinium)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Otology-Neurotology

Ear, Nose and Throat Associates of New York

Flushing

New York

NY

Disclosures

SG declares that she has no competing interests.

Peer reviewers VIEW ALL

Professor Neurological Surgery

Chief of Pediatric Otology

Otolaryngology Head and Neck Surgery

UT Southwestern Medical Center

Dallas

TX

Disclosures

PSR has acted as a consultant to Alcon laboratories, makers of Ciprodex®, who have provided compensation to the University of Texas Southwestern Medical Center Department of Otolaryngology Head and Neck Surgery. PSR has received compensation for speaking and for organizing educational events. PSR is co-author of the American Academy of Head and Neck Surgery's practice guideline for AOE. PSR is an author of references cited in this monograph.

Emeritus Professor of Otolaryngology

UCL Ear Institute

London

UK

Disclosures

AW declares that he has no competing interests.

Director ENT Unit

North Bristol NHS Trust

Honorary Reader in Otolaryngology

University of Bristol

Bristol

UK

Disclosures

DAN declares that he has no competing interests.

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