Otitis Externa

Question 1

Presentation of otitis externa

Answer 1

• Itch
• Pain
• Discharge
• Nectrotising/’malignant’ otitis externa:
  
  • Pain keeps them up at night
  • Diabetic/immunocompromised
  • +/- facial palsy or Abducens palsy

Question 2

Management of otitis externa

Answer 2

• Topical antibiotic drops
• Topical steroids
• Topical antifundals if fungal (black spores, cotton wool spots)
• Keep ear dry
• No cotton wool in ears
• For malignant otitis externa:
  
  • Require IV antibiotics with bone penetration for 6 weeks
  • CT temporal bones

Question 3

Predisposing factors

Answer 3

• Skin conditions (i.e. eczema, psoriasis)
• Systemic conditions (i.e. DM)
• Cotton bud use
• Cosmetics