External otitis, also known as swimmer’s ear, or swimmer’s ear, is one of the most frequent ear infections during the summer period. It is generally caused by environmental factors, but it can also be linked to repeated manipulation of the ears, or even to deformations. She reach children more easily, but many adults are also confronted with it. Insights from Dr Laurent Gaillardin, ENT doctor.
Definition: what is otitis externa?
External otitis refers to inflammation of the skin of the outer auditory canal of the ear. “It’s the most painful otitis, assures Dr. Gaillardin, we can’t miss it”. And to specify: “the external auditory canal extends from the flag of the ear to the lateral surface of the eardrum”.
Internal, middle or external otitis: what is the difference?
There are several types of otitis, depending on their location:
- l’otitis externawhich affects the external auditory canal;
- l’otitis mediawhich touches the middle ear (at the back of the eardrum);
- and theotitis internewhich affects the inner ear (at the level of the vestibule and the cochlea).
Symptoms: how do you know if you have otitis externa?
External otitis is often manifested by itching in the ear canal (pruritus). Then come the pains in the ear (otalgia).
The pain is very intense and throbbing, especially at night, to such an extent that it handicaps many patients on a daily basis, underlines Dr. Gaillardin.
Because ? “The nerves of the external auditory canal are very sensitive“, says the doctor.
Other symptoms are added to these pains:
- a clear discharge, then purulent and foul-smelling, in the ear (otorrhea);
- swelling and redness in the external auditory canal;
- more rarely, swelling around the ear and swollen and painful glands in the neck.
Note: Patients with otitis externa do not have a fever (if so, it is certainly malignant otitis externa).
How do you know if it is getting worse? What are the potential complications ?
External otitis should be taken seriously: consult your doctor as soon as the pain intensifies or lasts over time. Likewise if you notice purulent and foul-smelling discharge from your ears.
If otitis is not treated quickly, it can:
- become chronic (persist beyond three or four weeks) or repeat offender (more than 4 episodes per year).
- progress to malignant otitis externa (also called necrotizing), a rare and very severe infection that spreads to the temporal bone of the skull, causing a potentially fatal bone infection (osteomyelitis). Note: this infection most often affects diabetic or immunocompromised patients in the broad sense.
How long does otitis externa last in adults? And in the child?
External otitis lasts on average seven to ten daysprovided it is properly supported.
However, if the contributing factors are not identified and eliminated, recurrences are frequent.
Causes: how do you get otitis externa?
External otitis is related to a bacterial or fungal infection from the external auditory canal of the ear:
- if it is a bacterial infection (about 90% of cases), they are caused by the bacteria Pseudomonas aeruginosa where the Staphylococcus aureus (Staphylococcus aureus) ;
- if it is a fungal infection (about 10% of cases), they are caused by the fungus Aspergillus.
What are the main risk factors?
There are many behavioral risk factors and environments :
- scratching or washing your ears inadvertently;
- using cotton swabs;
- the fact of using irritating products;
- bathing in the pool;
- the presence of an earwax plug (especially if it is large and hard);
- wearing ill-fitting hearing aids;
- etc.
More certain anatomical factors also play a role, such as having a long and narrow or constricted external auditory canal, which complicates the evacuation of earwax and promotes maceration.
Finally, some diseases (diabetes, psoriasis, eczema, seborrheic dermatitis, etc.) or taking certain medications (antibiotics or immunosuppressants) may be implicated.
How to prevent otitis externa?
Several preventive measures can limit the occurrence of otitis:
- use earplugs during your aquatic escapades;
- dry your ears properly after swimming, showering and bathing;
- prefer sprays or oriculis to cotton swabs to clean his ears;
- treat skin diseases that affect areas near your ears and avoid scratching your ears.
How to soothe the pain of otitis externa?
It may seem obvious, but it’s important to remember that if there is ear pain, you should definitely not use a cotton swab, tweezers, pen or even a needle to try to unblock your ears! Not only is it ineffective, but it is also very dangerous…
To relieve pain in your ear, carefully follow these tips:
- stay hydrated regularly and throughout the day (water, herbal teas, teas, juices, etc.);
- blow your nose as soon as necessary and clean your nasal passages regularly using saline or saline solution;
- and watch your diet : limit foods that are too fatty or too sweet. This allows your body to focus on the immune system rather than the digestive system. Bet on raw or cooked fruits and vegetables, proteins and omega-3s.
In addition, to boost your immunity, bet on vitamin D capsules and bee products.
Treatment: analgesics, antibiotics, ear drops, how to cure otitis externa quickly (with or without a prescription)?
“The treatment of otitis externa consists of applying antibiotic ear dropsif the infection is of bacterial origin, or antifungal ear dropsif the infection is of fungal origin”, says Dr. Gaillardin. This treatment usually lasts 7 to 10 days, with a frequency of 2 to 4 instillations per day.
“You can also prescribe a calibrating dressing to be placed in the external auditory canal to allow the drops to penetrate well and to maintain a sufficient concentration of antibiotics”, adds the doctor. This dressing remains in place for three to five days in the ear and can fall off on its own or be withdrawn in consultation.
THE oral antibioticsthey are reserved for serious or recalcitrant ear infections
Depending on the level of pain, the doctor may prescribe level 1 analgesics (usually paracetamol) or level 2 (codeine, even tramadol). Note: non-steroidal anti-inflammatory drugs (NSAIDs) for analgesic purposes are not recommended due to the possible occurrence of serious infectious complications.