Otitis Externa

Question 1

What is otitis externa?

Answer 1

• Diffuse inflammation of the skin of the external auditory meatus

Question 2

What is the aetiology of otitis externa?

Answer 2

• Bacterial
• Pseudomonas aeruginosa
• Staphylococcus aureus

Question 3

What are the clinical features of otitis externa?

Answer 3

• Severe otalgia

- Impact on QOL: sleep disturbance/inability to work or exercise

Question 4

What is the condition more commonly known as (helpful for MCQ stems)?

Answer 4

• Swimmer’s ear

Question 5

What are some clues that may indicate malignant otitis externa?

Answer 5

• Fever, disproportionate pain, or a poor response to first line treatment, particularly in people with diabetes or immunocompromise

Question 6

If you suspect a malignant otitis externa what must you do?

Answer 6

• SAME DAY REFERRAL TO ENT

Question 7

How are the majority of otitis externa patients managed?

Answer 7

• With up to 14 days of topical treatment
• Prescribe suitable eardrops e.g. containing antibiotic and anti-inflammatory: Gentisone-HC contains gentamicin and hydrocortisone appropriate for most bacteria including anaerobes such as pseudomonas

Question 8

If topical antibiotics do not work after 14 days of treatment what must you do?

Answer 8

• Referral to emergency ENT clinic