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External Ear Infection (Otitis Externa)

Inflammation and infection of the external auditory canal, often called swimmer's ear.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is External Ear Infection (Otitis Externa)?

Otitis externa is an acute or chronic inflammatory condition of the external auditory canal (EAC) skin and underlying soft tissue. The most common pathogens are Pseudomonas aeruginosa and Staphylococcus aureus, while fungi such as Aspergillus and Candida cause otomycosis. Risk increases with prolonged moisture (swimmer's ear), trauma from cotton swabs, narrow canals and dermatologic conditions like eczema or psoriasis.

Pathophysiology involves disruption of the protective cerumen barrier, alkalinization of the canal pH and microbial overgrowth. Inflammation produces edema, debris accumulation and purulent or serous discharge that may obstruct the canal and cause conductive hearing loss. Severe cases progress to canal swelling, periauricular cellulitis and lymphadenopathy.

Necrotizing (malignant) otitis externa is a serious variant in immunocompromised, diabetic or elderly patients caused by Pseudomonas extending to skull base osteomyelitis. It requires prolonged systemic antibiotics, imaging (CT/MRI, gallium scan) and ENT consultation due to risk of cranial nerve palsies.

Symptoms

Ear pain (otalgia) worsened by chewing or tragus pressure
Itching and fullness sensation in the ear
Otorrhea (clear, white, yellow or foul-smelling discharge)
Conductive hearing loss from canal obstruction
Erythema and edema of the canal walls
Tenderness and swelling of the auricle
Periauricular lymphadenopathy in severe cases

Risk Factors

Frequent water exposure (swimming, surfing)
Use of cotton swabs and ear plugs
Hearing aids and earphone use
Atopic dermatitis or psoriasis affecting the canal
Diabetes mellitus and immunosuppression
Hot and humid climates
Narrow ear canals or exostoses

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe ear pain not responding to analgesics
  • Profuse otorrhea or canal obstruction
  • Hearing loss persisting more than a few days
  • Diabetic patients with severe otalgia (rule out malignant OE)
  • Fever, facial paralysis or vertigo

Treatment Methods

01
Microsuction or irrigation to clear debris
02
Topical antibiotic + corticosteroid ear drops (ciprofloxacin/dexamethasone)
03
Antifungal drops for otomycosis (clotrimazole)
04
Pope wick insertion when canal is severely edematous
05
Oral analgesics (NSAIDs, acetaminophen)
06
Strict water precautions during therapy
07
Systemic antibiotics for cellulitis or malignant OE
08
Patient education: avoid cotton swabs, dry ears after bathing

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.