Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Mar 29;116(13):224-234.
doi: 10.3238/arztebl.2019.0224.

Otitis Externa

Susanne Wiegand  1 , Reinhard Berner, Antonius Schneider, Ellen Lundershausen, Andreas Dietz
Affiliations
Review

Otitis Externa

Susanne Wiegand et al. Dtsch Arztebl Int. .

Abstract

Background: Otitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms.

Methods: This review is based on publications retrieved by a selective search of the pertinent literature.

Results: The treatment of acute otitis media consists of anal- gesia, cleansing of the external auditory canal, and the appli- cation of antiseptic and antimicrobial agents. Local antibiotic and corticosteroid preparations have been found useful, but there have been no large-scale randomized controlled trials of their use. Topical antimicrobial treatments lead to a higher cure rate than placebo, and corticosteroid preparations lessen swelling, erythema, and secretions. Oral antibiotics are indi- cated if the infection has spread beyond the ear canal or in patients with poorly controlled diabetes mellitus or immuno- suppression. Chronic otitis externa is often due to an under- lying skin disease. Malignant otitis externa, a destructive infection of the external auditory canal in which there is also osteomyelitis of the petrous bone, arises mainly in elderly diabetic or immunosuppressed patients and can be life- threatening.

Conclusion: With correct assessment of the different types of otitis externa, rapidly effective targeted treatment can be initi- ated, so that complications will be avoided and fewer cases will progress to chronic disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1
a) Normal right external auditory canal, with view of the eardrum. b) Swollen introitus of the right external auditory canal in a patient with acute otitis externa. c) An external auditory canal affected by bacterial otitis externa. d) Otomycosis
Figure 2
Figure 2
Treatment algorithm for acute otitis externa (modified from Rosenfeld et al. [8])
Figure 3
Figure 3
Exposed bone in the floor of the external auditory canal in a patient with malignant otitis externa
See this image and copyright information in PMC

References

    1. Leitlinie der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin (DEGAM) Ohrenschmerzen. www.awmf.org/uploads/tx_szleitlinien/053-009l_S2k_Ohrenschmerzen_2014-12... (last accessed on 25 January 2019)
    1. Neher A, Nagl M, Scholtz AW. Otitis externa. HNO. 2008;56:1067–1080. - PubMed
    1. Stroman DW, Roland PS, Dohar J, Burt W. Microbiology of normal external auditory canal. Laryngoscope. 2001;111:2054–2059. - PubMed
    1. Raza SA, Denholm SW, Wong JC. An audit of the management of otitis externa in an ENT casualty clinic. J Laryngol Otol. 1995;109:130–133. - PubMed
    1. van Balen FA, Smit WM, Zuithoff NP, Verheij TJ. Clinical efficacy of three common treatments in acute otitis externa in primary care: randomised controlled trial. BMJ. 2003;327:1201–1205. - PMC - PubMed

Substances