Incidence and management of otitis extera

Abstract

Otitis externa is the generic term for any inflammatory condition of the external auditory meatus (EAM). It may be a local phenomenon or part of a generalised skin condition. Otitis externa can be subdivided into acute, recurrent-acute and chronic. Erythema and swelling of the EAM skin with variable discharge/moist debris. Otitis externa was most common during the third decade of life, with significant difference between males & females and house wives were mostly affected. Infective otitis externa is much commoner than reactive type. Unilateral otitis externa was as twice as bilateral infection. The commonest predisposing factors were self cleaning of the ear followed by exposure to water. The study included 100 patients (114 ears) with otitis externa for the period from the April, 2009 to January, 2010 all are seen at the ENT department of Rizgary Teaching Hospital. Data concerning the patient's age, sex, occupation, side of affection, predisposing factors, the symptoms of otitis externa, the types of otitis externa and treatment, were collected and analyzed. In our study among 107 ears, 50% of ears (54) were treated with aural wick using antibiotic/steroid for those with bacterial infection and anti fungal ointment, for those with fungal infection. All the patients showed good response, while in the remaining 50% of ears (53) aural drops used, of same component of the aural wick, in which only19 ears ( 35%) of them showed good response while the remaining ears 34 ears (64%) showed no response so the treatment changed to an aural wick with good response and the explanation for that the aural wick is put directly by the otolaryngologist to the external auditory meatus as that confirm the patient was received the treatment and the direct application of the drug to the site of the inflammation, in contrast the use of drop give poor result may be the faulty use of the drop by the patient or not follow the instruction of the usage of the drop regarding the dose , time and the way of application of the drop, beside that the extensive edema of the canal will not allow the direct contact of the drug or reaching it to site of the inflammation that make the proper dose not taken by the patient. Key words: Otitis externa, bacterial infection, anti fungal ointment, otolaryngologist