Otitis externa, also known as swimmer's ear, is an inflammation of the external auditory canal, most often caused by an infection that develops due to exposure to water. Water entering the ear from swimming or bathing can wash away the protective layer of wax, creating favorable conditions for the growth of bacteria and fungi. The main causative agents of otitis externa are bacteria such as *Pseudomonas aeruginosa* and *Staphylococcus aureus*. Clinical manifestations include ear pain, itching, swelling, a feeling of fullness in the ear, and, in severe cases, purulent discharge. Without proper treatment, otitis externa can lead to complications such as spread of infection to surrounding tissues.
History of the disease and interesting historical facts
External otitis has been known since ancient times. Hippocrates' medical treatises mention cases of ear inflammation that were probably external otitis. In the modern era, with the development of water sports such as swimming, surfing and diving, the incidence of the disease has increased significantly, especially among swimmers. That is why external otitis has received the popular name "swimmer's ear". In the 20th century, with the spread of antibiotics and antibacterial drugs, the treatment of external otitis has become much simpler and more effective, which has reduced the incidence of complications.
Epidemiology
External otitis is common among people who frequently engage in water sports, as well as among residents of warm and humid regions. According to statistics, about 10% of the population at least once in their life faces external otitis. The incidence rate increases in the summer, when people spend more time in the water. According to WHO, external otitis is one of the most common reasons for seeking medical help for people with ear diseases, especially in regions with hot climates. Children and young adults are most susceptible to the disease.
Genetic predisposition to this disease
There is no known direct genetic predisposition to developing otitis externa. However, research suggests that genetic factors that affect sebum composition and skin function may indirectly contribute to a predisposition to outer ear infections. For example, people with genetically determined skin conditions such as atopic dermatitis or psoriasis may be more susceptible to otitis externa due to an increased tendency for the skin to become inflamed and to have compromised protective barriers.
Risk factors for the development of this disease
The main risk factors for developing otitis externa include:
— Frequent exposure to water (especially in swimming pools or open water).
— High air humidity and hot climate.
— Mechanical damage to the skin of the ear canal (for example, using cotton swabs).
— The presence of skin diseases such as eczema or seborrheic dermatitis.
— Use of hearing aids or headphones, which can create conditions for the growth of bacteria.
- Decreased immune system function, which can weaken the body's defenses against infections.
Diagnosis of this disease
Diagnosis of otitis externa is based on history and clinical examination. The main symptoms include:
— Pain in the ear, which intensifies when pressing on the auricle.
- Itching sensation in the ear canal.
- Swelling and redness of the external auditory canal.
- Ear congestion and hearing loss.
- Purulent discharge from the ear in more severe cases.
To diagnose, the doctor performs an otoscopy, which allows you to visualize the inflammation and exclude other causes of ear pain, such as otitis media or perforation of the eardrum. In some cases, a smear from the ear canal for microbiological testing may be taken to determine the causative agent of the infection.
Treatment
Treatment of otitis externa depends on the severity of the disease and its pathogen. The main treatment methods are:
— Cleaning the ear canal from exudate and dirt.
— Local use of antibacterial ear drops containing antibiotics (eg, ciprofloxacin) and corticosteroids to relieve inflammation.
— For fungal infections, antifungal drops are prescribed (for example, clotrimazole).
— In case of severe pain, analgesics may be prescribed.
— In severe cases, when external otitis does not respond to treatment with local remedies, systemic antibiotics may be prescribed.
Surgical treatment is usually not required unless complications such as abscesses occur.
List of medications used to treat this disease
- Ciprofloxacin (ear drops).
— Polymyxin B/neomycin (combination ear drops).
- Gentamicin (ear drops).
- Clotrimazole (ear drops for fungal infection).
— Corticosteroids (eg, dexamethasone, hydrocortisone to relieve inflammation).
Disease monitoring
Patients with otitis externa need regular examinations to assess the effectiveness of treatment and prevent possible complications. The prognosis for otitis externa is favorable in most cases, provided that treatment is timely and adequate. Repeated examinations help prevent chronicity of the disease and relapses. Complications are rare, but are possible if the infection spreads to surrounding tissues, causing perichondritis or cellulitis.
Age-related features of the disease
Otitis externa can occur at any age, but the disease is most often diagnosed in children and adolescents, especially those who actively swim. In children, otitis externa is often accompanied by increased skin sensitivity and may be associated with an increased risk of recurrent episodes. In adults, the disease is usually milder, although older people with weakened immune systems may experience more severe forms of otitis externa and develop complications.
Questions and Answers
- What is otitis externa and why is it called "swimmer's ear"? Otitis externa is an inflammation of the outer ear canal, often caused by an infection that occurs after water gets into the ear. It is called "swimmer's ear" because it often occurs in people who spend a lot of time in water.
- What are the main symptoms of otitis externa? The main symptoms include ear pain, itching, a feeling of fullness in the ear, swelling of the ear canal and, in severe cases, purulent discharge.
- How is otitis externa treated? Treatment involves using antibacterial or antifungal ear drops, as well as cleaning the ear canal and using analgesics to relieve pain.
- Can otitis externa be prevented? Yes, avoiding getting water in the ear, practicing proper hygiene, and using ear drops after swimming can help prevent otitis externa.
- Can otitis externa recur? Yes, especially in people who are frequently in water or have skin conditions such as eczema, otitis externa may recur if not treated.
