Otitis externa Archives - Jeffrey Sterling, MD

It’s that time of year. Whether you’re getting purified in Lake Minnetonka (obscure pop culture reference alert) or your local watering hole, as the weather warms, a lot of people end up with swimmer’s ear. This is the time of year when certain bacteria and other organisms have their day in the (dirty) water and are waiting to infect you.

Acute otitis externa (aka swimmer’s ear) is an infection or inflammation of the outer ear and ear canal. It is a different infection that those inner ear infections that kids seem to get all the time; that would be otitis media. Those two infections may occur at the same time, although it isn’t likely. Otitis externa isn’t just caused by polluted water; anything that causes inflammation or infection can cause it. For example, otitis externa may be a consequence of a bite or scratch to the ear or a foreign body in the ear (yet another reason to inserting cotton swabs or other objects into the ear).

If you develop acute otitis externa, you’ll know it. Symptoms include itching and pain, pus-like drainage from the ear and hearing loss. Unlike those inner ear infections, in otitis externa you may notice the pain is pronounced when you pull on the outer portion of the ear.
The interesting thing about treatment of otitis externa is it isn’t that complicated and usually gets better promptly. What is complicated about it is failure to get treated can result in some serious complications. Treatment is accomplished by giving antibiotic eardrops. Some of you who have have swimmer’s ear may recall the use of an ear wick to facilitate the drops making their way to the end of the ear canal. Other treatments may include oral antibiotics, topical steroids, pain medication and vinegar eardrops (the acid in the vinegar works to prevent further growth of bacteria).
Regarding you placing vinegar in the ear yourself: it is often stated that mixing one drop of white vinegar with one drop of alcohol and placing this into the ear can help. My advice to you is regardless of any home remedies or over-the-counter measures you take, you should get evaluated because of the risk of complications if not adequately treated. Placing any object – even fluid – in your ear presents additional risks, particularly in those rare instances in which the eardrum has ruptured. I subscribe to the old adage that you shouldn’t place anything in your ear smaller than your elbow.

Regarding complications, because of the aggressive nature of the bacteria causing acute otitis externa (named Pseudomonas), things can take a dramatic turn for the worst.

Infectious acute otitis externa may spread to other areas including the skull bone, causing an infection known as osteomyelitis.
In those with reduced immunity, diabetics or the elderly, the infection may become severe and life threatening. This is called malignant otitis externa.

Protecting yourself from swimmer’s ear isn’t that difficult. It mainly requires you to think about the possibility, mostly when you’re getting water in your ears.

Avoid swimming in polluted water.
Avoid placing any objects such as cotton swabs in your ears. It’s ok and helpful to use earplugs when swimming.
Ensure water doesn’t get into your ears when bathing, shampooing or showering. Thoroughly dry the ear after exposure to moisture.

We welcome any questions you may have.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

So here I am again waiting for something interesting to walk in worthy of me telling you about, and lo and behold, a behemoth of a guy walks by. You know, one of those guys who works out way too much for it to be just about health. In any event, the nurse tells me the gentleman has ear pain, and she thinks it’s an infection. Well, that’s odd. Otitis media (middle ear infections) and otitis externa (external ear infections) usually happen in kids. So I get up to see him, and I see something that looks like an early version of Randy Couture’s ear… …and I immediately think of you.
A ‘cauliflower ear’ is something you should be aware of because it’s easily obtained, and it has very bad consequences if not addressed in a timely manner. It’s a deformity of the ear (usually the upper outer portion) mostly caused by blunt trauma. It happens a lot to wrestlers, boxers, MMA fighters and rugby players, but it’s also seen in those with infected high ear-piercings. It occurs when the ear gets hit, causing a hematoma (collection of clotting blood) to form. The hematoma prevents normal flow of blood through the ear. The problem with this is the ear is made of cartilage (a less sturdy form of tissue) than bone. No blood flow and the presence of clots cause the cartilage to wilt and deform, giving the lumpy appearance shown in the picture. This can be treated with drainage of the blood and clot from the ear, but if it’s not done early enough, the ear will become permanently deformed.
If you have trauma or infection to the upper ear, be on the lookout for redness or swelling. Don’t ignore it like you might be inclined to do elsewhere. Get it evaluated promptly, even if it seems minor because… Time is tissue.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Tag Archives: Otitis externa

Straight, No Chaser: Swimmer's Ear (Acute Otitis Externa)

Straight, No Chaser: Emergency Room Adventures – The Cauliflower Ear