Definition Chronic otitis externa is a persistent inflammation of the ear canal.
What is going on in the body? Chronic otitis externa occurs when there is persistent trauma to or inflammation of the ear canal. This can occur for different reasons, such as infection. This persistent inflammation can lead to symptoms.
What are the signs and symptoms of the condition? One of the most prominent symptoms of chronic outer ear inflammation is itching in the ear canal. Other symptoms include low-grade pain and flaky skin. There is rarely any infected drainage material, severe tenderness, or hearing loss.
What are the causes and risks of the condition? Repetitive trauma to the ear canal in the form of Q-tips, bobby pins, or other objects can alter the normal skin replacement pattern of the ear canal. Fungal or bacterial infections on the surface of the ear canal skin can also be a cause. With fungal infections, the skin of the ear canal becomes quite thick, and when peeled off, there is significant redness of the underlying skin. In certain situations there may be mould forming on the skin of the ear canal. Use of some antibiotic eardrops that contain neomycin, can cause a chronic inflammation that can be similar to poison ivy. Therefore, these medications need to be used with some caution. Excessive dryness of the ear canal is also a factor.
What can be done to prevent the condition? Avoidance of trauma to the ear canal will prevent many cases. Many doctors discourage the use of Q-tips and most other objects to clean the ear canal. Keeping the ear canal dry and free of wax will help prevent some cases. A simple eardrop solution can work well to keep the ear canal dry. Avoidance of neomycin-containing drugs may prevent some cases as well.
How is the condition diagnosed? This condition is diagnosed by examining the outer ear structures. Often thinning of the ear canal skin, flaky skin, or flaky, dried, yellow material is present. In fungal forms, the skin of the ear canal may be thickened and can easily be removed. The underlying skin is often intensely red.
What are the long-term effects of the condition? The main long-term effect would be continued thickening of the skin of the ear canal to the point where the ear canal would be blocked and hearing loss would occur. Most cases do not cause any long-term effects.
What are the treatments for the condition? Treatment often depends on the cause of the inflammation.
For chronic otitis externa caused by repetitive trauma, treatment involves stopping the trauma to the ear canal. Persons may be advised to stop using Q-tips, for example.
People with fungal forms need to have the surface of the diseased skin removed. Ointments containing antifungal and corticosteroid medication may be applied to the ear canal. Other topical types of therapy may also be used in some cases.
If the disorder is caused by chronic bacterial infections, then antibacterial drops often restore the external canal to a normal, healthy state.
If dryness is a cause, then several drops of baby oil in the ear canal will keep the skin moist.
For the rare blocked ear canal, the scarred lining of the canal must be removed and skin grafts placed to reline the bone.
What are the side effects of the treatments? Side effects depend on the medication used to treat the underlying cause. Care must be used if ointment is applied into the external canal, particularly if a Q-tip is used, to avoid perforation to the eardrum.
What happens after treatment for the condition? Most cases of chronic otitis externa will completely resolve with the right treatment. Some people continue to have a need for regular medical management.
How is the condition monitored? How closely the condition is monitored depends on the intensity of the symptoms. A doctor should be called if any acute symptoms, such as pain, drainage, or tenderness of the ear canal, are present.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
