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Malignant Otitis Externa - Symptoms and Treatment

Otitis externa refers to an infection of the ear canal (outer ear), the tube leading from the outside opening of the ear in towards the eardrum. It may be acute, chronic, or invasive and it is most common in the summer among children and young adults. With treatment, acute otitis externa usually subsides within 7 days (although it may become chronic) and tends to recur.

Malignant otitis extern a is potentially life threatening and most commonly occurs in controlled diabetic patients. It is caused by Pseudomonas aeruginosa and slowly invades from the external canal into adjacent soft tissues, mastoid, and temporal bone. Otitis externa, or swimmer's ear, usually starts out as a nagging itch, brought on by a softening of the protective lining of the ear canal. However, it can blossom into as painful an infection as you will ever experience. For adults, swimmer's ear is the second most common cause of ear pain after TMJ (temporo-mandibular joint) syndrome.

Causes of Malignant Otitis Externa

Find common causes and risk factors of Malignant Otitis Externa:

  • Diabetes.
  • Medical conditions resulting in a compromised immune system .
  • Frequent swimming or showering, particularly in young children who have narrow ear canals .

Signs and Symptoms of Malignant Otitis Externa

Sign and symptoms may include the following :

  • Fever
  • Hearing loss
  • Redness and/or itching inside the ear canal
  • Drainage from the ear .

Treatment for Malignant Otitis Externa

Treatment may include:

  • For mild chronic otitis externa, treatment may include instilling antibiotic eardrops once or twice weekly and wearing specially fitted earplugs while showering, shampooing, or swimming.
  • Instillation of slightly acidic eardrops creates an unfavorable environment in the ear canal for most fungi as well as Pseudomonas.
  • Primary treatment of chronic olitis externa consists of cleaning the car and removing debris. Supplemental therapy includes instillation of antibiotic eardrops or application of antibiotic ointment or cream (neomycin, bacitracin, or polymyxin, possibly combined with hydrocortisone). Another ointment contains phenol, salicylic acid, precipitated sulfur, and petrolatum, and produces exfoliative and anti pruritic effects.
  • As with other forms of this disorder, fungal otitis externa necessitates careful cleaning of the ear. Application of a keratolytic or 2% salicylic acid in cream containing nystatin may help treat otitis extern a resulting from candidal organisms.





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