小结
病史和体格检查
关键诊断因素
- 存在的危险因素
- 耳痛
- 耳屏和/或耳廓压痛
- 外耳道肿胀和红斑
- 耳道肉芽组织（坏死性外耳炎）
其他诊断因素
- 耳漏
- 耳胀满感
- 瘙痒
- 听力下降
- 下颌运动会加剧疼痛
- 红斑性鼓膜
- 耳廓和邻近皮肤的蜂窝织炎
危险因素
- 外耳道阻塞
- 高湿度环境
- 较高的环境温度
- 游泳
- 局部外伤
- 化学刺激剂
- 过敏
- 皮肤病
- 糖尿病
- 免疫功能低下
- 长期使用局部抗菌药物
诊断性检查
首要检查
- 鼓气耳镜检查
- 声导抗检查
需考虑的检查
- 耳分泌物培养
- 外耳道分泌物/碎屑的显微镜检查
- 静脉使用对比剂的颞骨 CT 扫描
- 脑部和内听道 MRI（可使用和不使用钆）
- 红细胞沉降率 (ESR)
治疗流程
细菌
真菌
撰稿人
作者
Soha Ghossaini, MD, FACS
Otology-Neurotology
ENT and Allergy Associates LLP
Flushing
New York
NY
利益声明
SG declares that she has no competing interests.
鸣谢
We would like to acknowledge our ENT expert panel member, Dr Lawrence Lustig, for his contribution to this topic. Dr Lustig declares that he has no competing interests.
同行评议者
Peter S. Roland, MD
Professor Neurological Surgery
Chief of Pediatric Otology
Otolaryngology Head and Neck Surgery
UT Southwestern Medical Center
Dallas
TX
利益声明
PSR has acted as a consultant to Alcon Laboratories, maker of Ciprodex®, which has 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 organising educational events. PSR is co-author of the American Academy of Head and Neck Surgery's practice guideline for acute otitis externa. PSR is an author of references cited in this topic.
Anthony Wright, LLM, DM, FRCS
Emeritus Professor of Otolaryngology
UCL Ear Institute
London
UK
利益声明
AW declares that he has no competing interests.
Desmond A. Nunez, MD, FRCS(ORL)
Director ENT Unit
North Bristol NHS Trust
Honorary Reader in Otolaryngology
University of Bristol
Bristol
UK
利益声明
DAN declares that he has no competing interests.
鉴别诊断
- 急性中耳炎
- 疖病
- 外耳道接触性皮炎
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