Otitis externa is an infection of the outer ear canal. This condition usually occurs due to the entry of water into the ear when bathing or swimming and the water cannot get out, so that the condition of the ear canal becomes moist and triggers the growth of bacteria.
Otitis externa attacks the outer ear canal, which is the part between the ear canal and the eardrum. This infection is more common in swimmers. Therefore, this disease is also known as swimmer's ear.
Causes of Otitis External
Otitis externa is usually caused by a bacterial infection Staphylococcus aureus or Pseudomonas aeruginosa. These bacteria can grow in the ear due to:
- The condition of the ear canal that is too humid, either due to excessive sweating, humid weather, or water trapped in the ear
- The ear canal is scratched or blistered, for example due to scratching the ear canal with fingers, cleaning the ear with cotton bud, use earbuds, or use a hearing aid
- Irritation or allergic reactions, for example due to the use of hair care products or shampoos that accidentally enter the ear canal
- Skin diseases that can attack the ear canal, such as dermatitis and psoriasis
Otitis externa can actually also be caused by a fungal infection. However, the case is rare.
Risk Factor Otitis Externa
Some factors that can increase a person's risk of developing otitis externa are:
- Swimming, especially in places that contain a lot of bacteria, such as in lakes
- Has a narrow ear canal shape, so it can make water trapped in the ear
- Cleaning the ear too often or too hard, causing the inside of the ear to be scratched
- Using a hearing aid or earbuds
- Suffering from allergies or skin irritation
Symptoms of Otitis External
People with otitis externa usually feel mild symptoms at first, such as:
- Itching and redness in the ear canal
- Clear, odorless discharge or pus from the ear
- Pain when the bulge in front of the ear canal (tragus) is pressed or when the earlobe is pulled
- The ear canal feels full and somewhat clogged due to swelling or too much fluid and earwax
- Decreased hearing ability
- Itching that gets worse
- Ears are red and swollen
- Pain in the ear radiating to the face, neck and head
- Swollen lymph nodes in the neck
- Totally blocked ear canal
- Fever
When to go to the doctor
Immediately see a doctor if you experience the above symptoms, especially if the pain gets worse and is accompanied by a fever. By undergoing early examination and treatment, you can reduce the risk of complications.
Otitis Externa Diagnosis
The ENT doctor will ask about the patient's symptoms and habits, especially habits that are at risk of causing otitis externa. Next, the doctor will pull the earlobe and press on the tragus, the bulge in front of the ear, to see if the patient feels pain.
The doctor will also see the patient's ear canal and eardrum using a special instrument in the form of a small lighted binocular called an otoscope. This examination will help the doctor determine the severity of otitis externa.
If needed, the doctor will take a sample of fluid from the patient's ear canal for examination in the laboratory. Through this examination, the doctor can determine the type of bacteria causing the infection and the appropriate antibiotic to kill the bacteria.
Otitis Externa Treatment
The doctor will first clean the patient's ear canal, so that the ear drops seep into the entire infected area. The doctor may also use a curette or special instrument to remove wax from the ear.
Drugs that can be used to treat otitis externa include:
- Corticosteroids to treat inflammation
- Antibiotic or antifungal ear drops to kill the microorganisms that cause infection
- Drops to restore acidity levels in the inner ear, so bacteria can not grow
- Pain relievers, such as ibuprofen, naproxen, and paracetamol
- Take antibiotics if the infection is severe and attacks the skin around the ear.
To speed up the healing process, patients will be advised to avoid the following activities:
- Swimming or diving
- Take a shower without first closing the ear hole
- Using a hearing aid or earbuds before completely healed
- Traveling by airplane
Otitis External Complications
If not treated promptly, otitis externa can lead to the following serious complications:
- Temporary hearing loss, which usually improves after the infection is treated
- Long-term infection (chronic otitis externa), especially if the infection is caused by allergies, rare types of bacteria, or a combination of bacterial and fungal infections
- The infection spreads to the bone around the ear canal (necrotizing otitis externa)
- Infection of the connective tissue and the inner layers of the skin
Prevention of Otitis External
There are several steps that can be taken to prevent otitis externa, namely:
- Use ear protection when bathing or swimming, so that water does not enter the ear.
- Dry the outside of the ear after bathing or swimming. If water gets into your ear, tilt your head to let the water out.
- Consult your doctor first before swimming, if you have recently recovered from an ear infection or have recently had ear surgery.
- Do not insert objects that can cause cuts or scratches to the lining of the ear canal.
- Don't use cotton bud to clean the ear canal, because it will push the dirt in deeper.