External Otitis - Swimmer's Otitis

external - also called swimmer's otitis - is an inflammatory process affecting the external auditory canal.

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Causes

Otitis externa is due to viral (mainly herpetic), bacterial and sometimes fungal infections. More often, otitis externa is a consequence of eczema or purulent otitis media.

Among the predisposing factors for ear inflammation we remember: diabetes, cold, severe vitamin deficiencies, humidity, dryness of the ear canal.

Symptoms

The characteristic symptoms of otitis externa are: pain when chewing, edema, irritation and redness of the external ear, ear pain, impaired hearing.

Therapies

The most suitable therapy depends on the triggering cause: therapeutic aids (to relieve pain), antibiotics (in case of bacterial infection) and antivirals (if the cause of otitis externa depends on viral insults).

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"Otitis externa is a typical disease of swimmers: not surprisingly, it has also been renamed" swimmer's otitis ". The cause of the disease lies mainly in infections, easily treatable with emollient drops with cerumolytic action, antibiotics / antivirals and possibly corticosteroids .

almost exclusively bacterial, although it can sometimes be caused by fungal or viral infections.

The bacteria most involved in the disease are Pseudomonas aeruginosa And Staphylococcus aureus.

What factors favor the appearance of external otitis?

Several factors can increase the risk of otitis externa:

• Absence of earwax.
• Continuous swimming in the pool: swimmers are prone to the formation of otitis externa since repeated exposure to water, with the subsequent "mechanical" removal of earwax, can damage the external auditory canal making the area more prone to bacterial attacks. stagnation of water inside the ear canal can create a favorable environment for the proliferation of bacteria.
• Otitis media: It is not uncommon for swimmer's otitis to result from middle ear infections.
• High temperature and humidity.
• Ear washing with aggressive detergents: soaps, shampoos and shower gels can enter the ear canal and cause itching. The subject scratching the skin can damage the skin, thus creating a possible gateway for pathogens.
• Local trauma: they can be caused, for example, by incorrect cleaning of the ears (eg cleaning with cotton buds).

. Symptoms of acute otitis externa begin suddenly, usually within 48 hours of infection. The clinical picture is characterized by:

• Tinnitus (ringing in the ears)
• Bacterial cellulitis of the auricle (rare);
• Impaired hearing ability;
• Ear edema;
• Erythema (irritation, redness) of the ear and tympanic membrane;
• Tenderness to touch;
• Hyperemia (increased blood in the outer ear);
• Hypoacusis (reduced hearing);
• Lymphadenitis - inflammation of the lymph nodes;
• Ear pain (ear pain);
• Perception of "muffled" sounds;
• More or less intense itching;
• Sensation of auricular fullness;

Chronic External Otitis

The symptoms of chronic otitis externa are the same as in the acute form, but last for over 6 weeks.

Localized external otitis (furunculosis)

Ear inflammation is associated with hair follicle infections.

Eczematous External Otitis

Otitis externa is caused by extrainfectious factors, such as atopic dermatitis, lupus erythematosus, eczema and psoriasis.

Malignant Necrotizing External Otitis

It is a "serious infection that, starting from the" external ear, spreads to the deeper tissues, adjacent to the ear canal. The malignant necrotizing form of otitis generally affects immunocompromised (eg, AIDS), diabetic and defected patients. This form of otitis can cause serious complications, such as:

• Bacterial cellulitis;
• Osteomyelitis;
• Cervical paralysis;
• Deafness;
• Dizziness.

) can ascertain or deny a supposed external otitis: this diagnostic test highlights edema and hyperemia, characteristic elements of inflammation.

In some cases, it is necessary to proceed with the analysis of the tympanic membrane, to evaluate any damage: if so, the patient should go to the otolaryngologist for further tests.

Biopsy and culture of a sample of ear wax is also a diagnostic test used for otitis externa, useful for identifying the pathogen involved in the infection and its response to antibiotics (antibiogram).

it is essential to remove debris and pathogenic particles deposited in the basin of the eardrum: in such situations, the cleaning of the ears, carried out by the specialist, consists in removing the earwax by curettage or aspiration.

To block the infection, specific antibiotics (for bacterial ear infections) or antifungals (for fungal forms) are needed. Topical application of corticosteroid drugs can reduce inflammation, while the instillation of special ceruminolytic drops (slightly acid solution ) can favor the removal of waste and create an environment hostile to the attack of bacteria and other pathogens.

In conclusion, we remind you that prevention - consisting in thorough cleaning of the ears - is the most effective weapon against otitis externa.