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Otitis Externa - and Update PDF
Otitis Externa - and Update PDF
ABBREVIATIONS location and time course of illness. These include acute diffuse
AOE: Acute Otitis Externa; EAC:External Auditory Canal; OE: otitis externa, which is the main subject in this review, acute
Otitis Externa localized otitis externa, otomycosis, herpes oticus, dermatoses
and malignant otitis externa [5].
INTRODUCTION
Microbiology
Acute otitis externa is a condition that involves inflammation
of the external ear canal which may extend laterally to the pinna The bacterial flora of the EAC is predominantly composed
and proximally to the tympanic membrane resulting in otalgia, of gram positive organisms. The most commonly recognized
itching, canal edema, erythema and otorrhea. Soreness with microorganisms are Staphylococcus epidermidis (38%) and
movement of the tragus or pinna is a classic finding. Diptheroid (22.4%). Gram negative organisms are less prevalent,
isolated from <5% of the external auditory canal specimens.
This pathology often occurs after swimming or minor trauma Following prolonged water exposure, however, the flora of the
from inappropriate cleaning. Local defense mechanisms become EAC changes, becoming dominated by gram negative organisms.
disabled by prolonged ear canal wetness, and skin desquamation
leads to microscopic fissures that provide a portal of entry for Pseudomonas aeruginosa is the most frequent pathogen
infecting organisms. The acute diffuse form, which is this review in AOE, identified in 22-62% of cases in series on AOE.
main issue, is caused primarily by bacterial infection, with Staphylococcus aureus (11-34% of cases) is the most important
Pseudomonas aeruginosa and Staphylococcus aureus as the most gram positive pathogen [5-8].
common pathogens [1,2].
Risk factors
Each year, otitis externa is reported to affect four out 1000
There are several factors that can cause AOE, one of them
Americans of all age groups, and it affects males and females
being associated with dermatological disease of the ear canal
equally. The incidence is highest in children. A study from US
and conchal bowl, such as eczema and, less commonly, psoriasis.
reported that from 2003 to 2007, rates of ambulatory visits for
These abnormalities are more common in swimmers, humid
otitis externa were highest among children 5-9 years and 10-14
environments, in people with narrow external ear canals, in
years [3,4].
hearing aid users, and after mechanical trauma or ear syringing
Classification [9-11]. Otitis externa may also occur secondary to ear canal
obstruction by impacted cerumen, foreign object, a dermoid cyst,
Acute otitis externa can be classified based on its etiology,
sebaceous cyst, or furuncle [12].
Cite this article: Treviño González JL, Moreno KD (2017) Otitis Externa: And Update. Ann Otolaryngol Rhinol 4(8): 1195.
Treviño González et al. (2017)
Email:
Central
Central
DISCUSSION & CONCLUSION 11. Nussinovitch M, Rimon A, Volovitz B, Raveh E, Prais D, Amir J. Cotton-
tip applicators as a leading cause of otitis externa. Int J Pediatr
Acute otitis externa is a frequent health problem in young Otorhinolaryngol. 2004; 68: 433-435.
ages and there are many factors that can avoid the development
12. Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM,
of this disease, especially if physicians dedicate time to educate et al. Clinical Practice Guideline: Otitis Media with Effusion (Update).
patients in how to avoid recurrences of AOE. The most important Otolaryngol Neck Surg. 2016; 154: S1-S41.
issue is to avoid complications, which are not that frequent but
13. Mösges R, Nematian-Samani M, Eichel A. Treatment of acute otitis
can be deadly. externa with ciprofloxacin otic 0.2% antibiotic ear solution. Ther Clin
The correct management of diffuse external otitis is simple, Risk Manag. 2011; 7: 325-336.
and as mentioned in the review, topical preparations such as 14. Hughes E, Lee JH. Otitis Externa. Pediatr Rev. 2001; 22: 191-197.
ciprofloxacin make it easier to avoid side effects and give a more
15. Brook I. Treatment of otitis externa in children. Paediatr Drugs. 1999;
complete and effective therapy. 1: 283-289.
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