Otitis Externa.

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.