Introduction:

Chronic otitis externa, also known as swimmer’s ear, is a prolonged inflammation of the outer ear and ear canal. This condition, often painful, can significantly impact the quality of life and may lead to more serious complications if not adequately treated. Understanding the causes, symptoms, diagnostic criteria, and management strategies of chronic otitis externa is essential for effective treatment and relief.

Causes and Risk Factors:

• Prolonged exposure to moisture, as seen in swimmers, is a common cause.
• It can also be caused by allergic reactions to ear drops or hearing aids.
• Injuries to the ear canal from cotton swabs or other objects.
• Conditions like eczema or psoriasis that affect the skin can also predispose to otitis externa.
• Infections, bacterial or fungal, often exacerbate or trigger the condition.

Symptoms:

• Persistent itching in the ear canal.
• Redness and swelling of the outer ear and ear canal.
• Pain, which can be severe and may worsen when the outer ear is touched or pulled.
• Discharge from the ear, often foul-smelling.
• Hearing loss or a feeling of fullness in the ear due to swelling or blockages.

Diagnostic Evaluation:

• Diagnosis is typically made based on symptoms and examination of the ear.
• Examination with an otoscope to assess the ear canal and eardrum.
• Cultures or swabs from the ear may be taken to identify the infecting organism.
• In chronic or complicated cases, imaging studies like CT scans may be required.

Treatment and Management:

• Keeping the ear dry and avoiding water exposure is crucial.
• Topical treatments, including antibiotic or antifungal ear drops.
• Steroid ear drops to reduce inflammation and itching.
• Pain relief medications.
• For severe or refractory cases, oral antibiotics or antifungals may be necessary.
• Regular cleaning of the ear by a healthcare professional to remove debris and discharge.
• Addressing underlying skin conditions is also important.

Complications:

• Untreated otitis externa can lead to more severe infections, such as malignant otitis externa, especially in immunocompromised individuals.
• Chronic inflammation can cause narrowing of the ear canal.

Prevention and Patient Education:

• Keeping ears dry, especially after swimming or bathing.
• Avoiding the use of cotton swabs or other objects in the ear.
• Proper ear care and hygiene.
• Patients with skin conditions affecting the ear should manage these conditions proactively.

Conclusion:

Chronic otitis externa is a manageable condition, but it requires diligent care and treatment. Understanding and addressing the underlying causes, along with appropriate medical treatment, are key to resolving symptoms and preventing recurrences.

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