Otitis externa: Causes, Symptoms, Treatment and Cost

Otitis externa, sometimes referred to as swimmer's ear, is an infection or inflammation of the ear canal and outer ear brought on by bacteria or fungus. It is commonly seen in individuals who swim frequently or have excess moisture in the ear canal, but can also occur due to skin conditions, ear injuries, or allergies.

There are two types of otitis externa:

• Acute otitis externa: A rapid infection of the outer ear canal characterizes this kind of otitis externa, which results in swelling, discomfort, and inflammation. It often only lasts a short while and is treated with antibiotics and analgesics.
• Chronic otitis externa: This type of otitis externa is a long-term infection of the outer ear canal, which causes persistent inflammation, itching, and discharge. It is often caused by underlying skin conditions or allergies and requires long-term treatment with antibiotics and topical medications.

Some of the root causes of otitis externa include the following:

• Bacteria: Bacterial infection is the main cause of otitis externa. The syndrome is often linked to bacteria including Streptococcus pyogenes, Pseudomonas aeruginosa, and Staphylococcus aureus. Fungi: In some cases, otitis externa can be caused by fungal infections, such as Aspergillus or Candida.
• Moisture: Prolonged exposure to moisture in the ear canal, such as from swimming or excessive sweating, can create a favorable environment for bacterial and fungal growth, leading to infection.
• Trauma: Any injury to the ear canal's skin, such as scratching it or cleaning your ears with cotton swabs, might result in infection.
• Skin conditions: Certain skin conditions such as eczema, psoriasis, or seborrheic dermatitis can increase the risk of developing otitis externa.
• Foreign bodies: Objects such as earplugs, hearing aids, or other foreign bodies can irritate the ear canal, making it more susceptible to infection.
• Chemical irritation: Exposure to certain chemicals such as hair dyes or hair sprays can irritate the skin of the ear canal and lead to infection.
• Reduced immunity: Otitis externa is more common in those with compromised immune systems, especially those with HIV/AIDS or receiving chemotherapy.

Otitis externa symptoms often include:

• Ear pain: The most typical sign of otitis externa is this. The pain may be mild or severe and can worsen when the earlobe is pulled or when pressure is placed on the ear.
• Itching: The ear canal may feel itchy or irritated, and scratching can exacerbate the condition.
• Redness and swelling: The outer ear canal may be red and swollen, and the skin lining the canal may be flaky or scaly.
• Discharge: Some people with otitis externa may notice a pus-like discharge from the ear canal. The discharge may have an unpleasant odor.
• Hearing loss: Otitis externa may, in extreme instances, result in temporary hearing loss because it inflames and swells the ear canal.
• Fever: In rare cases, otitis externa can cause a fever, indicating that the infection has spread beyond the ear canal.

Otitis externa may be prevented in several ways:

• After swimming or taking a shower, wipe your ears completely with a towel to keep them clean and dry.
• Don't go swimming in polluted lakes or rivers.
• Avoid inserting objects into your ears, such as cotton swabs, which can damage the skin and increase the risk of infection.
• To keep water out of your ears when swimming, use earplugs or a swim hat.
• Eczema and psoriasis should be treated as soon as possible to reduce the risk of infection.
• Use ear drops with antibiotics and anti-inflammatory medications when recommended by your physician.
• Avoid prolonged or repeated exposure to moist environments such as humid conditions or sweat buildup in the ear canal by using alcohol-based ear drops after swimming or showering.
• Maintain proper hygiene by routinely washing your hands and refraining from sharing private objects like earphones or headphones.

These diagnostic tests can aid in the diagnosis of otitis externa, including:

• Otoscopy: An otoscope is a handheld instrument used to examine the ear canal and eardrum for signs of inflammation, redness, swelling, or discharge.
• Culture and sensitivity tests: A sample of the ear discharge may be collected and sent to a laboratory to identify the specific bacteria or fungi causing the infection and determine the appropriate treatment.
• Polymerase chain reaction (PCR) tests: PCR tests can detect the genetic material of bacteria or fungi in ear discharge samples, providing a more rapid and accurate diagnosis of the specific microorganism causing the infection.
• Imaging tests: In rare cases, imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI) may be ordered to rule out any underlying conditions that may be contributing to the symptoms.
• Allergy testing: If an individual has a history of recurrent or persistent otitis externa, allergy testing may be recommended to identify any allergens that may be contributing to the condition.

Otitis externa, if left untreated or inadequately treated, can lead to several complications, which include:

• Cellulitis: The infection can spread beyond the ear canal to the surrounding skin, causing redness, swelling, and pain.
• Abscess: A collection of pus can form in the affected area, leading to further pain and discomfort.
• Otitis media: Otitis media is an illness that may result from otitis externa spreading to the middle ear. Pain, a fever, and hearing loss may arise from this.
• Perichondritis: The infection can spread to the cartilage of the outer ear, leading to inflammation, tenderness, and deformity of the ear.
• Mastoiditis: In rare instances, the infection may progress to the mastoid bone, a bone behind the ear that may become inflamed and infected. This can cause pain, fever, and potentially serious complications.
• Hearing loss: Chronic or recurrent otitis externa can lead to permanent hearing loss if left untreated or inadequately treated.
• Facial nerve paralysis: Rarely, an infection may reach the facial nerve and cause facial paralysis or weakening.
• Meningitis: Very rarely, untreated otitis externa may result in meningitis, a bacterial infection of the brain and spinal cord. This is a dangerous condition that might endanger your life.

The following are some Home remedies that may be used for the treatment of otitis externa:

• Warm garlic oil: Garlic oil has antimicrobial properties and can help to reduce inflammation and pain. Warm garlic oil can be applied to the affected ear canal using a dropper, and the ear should be covered with a cotton ball.
• Tulsi (Holy Basil) leaves: Tulsi leaves have antibacterial and anti-inflammatory properties. Crushed tulsi leaves can be heated and applied externally to the affected ear.
• Turmeric paste: Antimicrobial and anti-inflammatory effects are present in turmeric. To treat the infected ear externally, make a paste of turmeric and water.
• Triphala decoction: Three fruits are combined to create Triphala, which has antibacterial and anti-inflammatory qualities. You may cleanse the troublesome ear with a Triphala decoction.
• Ghee: Ghee contains antibacterial qualities and may help to lessen pain and inflammation. A few drops of warm ghee can be applied to the affected ear canal using a dropper.
• Ayurvedic herbal oils: Several Ayurvedic herbal oils may be used to treat otitis externa, including neem oil, sesame oil, and coconut oil. These oils have antimicrobial and anti-inflammatory properties and can be applied externally to the affected ear.

Follow this list of food for quick recovery from Otitis externa

• Vitamin C and zinc-rich foods like leafy greens, citrus fruits, nuts, and seeds can help boost immunity and aid in the healing process.
• Lean proteins like fish, chicken, and tofu can provide essential nutrients without causing discomfort in the ear.
• Spicy and acidic foods such as tomatoes, vinegar, and hot peppers should be avoided as they can worsen inflammation and pain.
• Yogurt, kefir, and sauerkraut are examples of foods high in probiotics that may help balance out the good bacteria in the body and enhance digestion.
• Foods high in omega-3 fatty acids like salmon, chia seeds, and walnuts can help to reduce inflammation and support overall health.

These foods should be avoided if you are diagnosed with Otitis externa:

• Spicy and acidic foods: Foods that are extremely spicy or acidic can irritate the lining of the ear canal, leading to further inflammation and discomfort. Avoid foods like hot peppers, citrus fruits, vinegar-based dressings, and tomato-based products like ketchup or salsa.
• Dairy products: Milk, cheese, and yogurt are examples of dairy items that may enhance the body's production of mucus, making otitis externa symptoms worse.
• Processed and sugary foods: The immune system may get weakened by processed and sugary diets, making it more challenging to fight off diseases like otitis externa.Avoid foods like candy, baked goods, chips, and other processed snacks.
• Alcohol and caffeine: Alcohol and caffeine can both dehydrate the body, which can make it more difficult to recover from otitis externa.It is better to avoid or consume these things in moderation while the virus is active.
• Fried foods: Fried meals include a lot of bad fats, which might make the body more prone to inflammation. Steer clear of fried meals including fried snacks, fried poultry, and french fries.
• Nuts and seeds: The high phytic acid content in nuts and seeds might hinder the body's ability to absorb some nutrients. The body may find it more challenging to fight off infections like otitis externa as a result.
• Soy products: Soy products like tofu and soy milk can trigger allergic reactions in some people, which can worsen otitis externa symptoms. If you suspect that soy is contributing to your symptoms, it's best to avoid it until you can see a healthcare provider for further evaluation.

The following are some surgical procedures that may be used to treat otitis externa:

• Myringotomy: This is a surgical procedure in which a small incision is made in the eardrum to drain fluid or pus that has accumulated in the middle ear. This may be necessary if otitis externa has progressed to otitis media, which is an infection of the middle ear.
• Tympanoplasty: The eardrum may be repaired surgically using this technique. It may be necessary if the eardrum has been damaged by chronic or recurrent otitis externa.
• Mastoidectomy: The mastoid bone, the bone behind the ear, may be treated surgically by removing sick or contaminated tissue. It may be necessary if otitis externa has progressed to mastoiditis, which is an infection of the mastoid bone.
• Canaloplasty: To remove damaged or contaminated tissue from the ear canal, a surgical technique is. It may be necessary if otitis externa is severe or chronic and conservative treatments have failed.
• Excision of aural polyp: This is a surgical procedure that is used to remove a polyp, which is a growth that can occur in the ear canal as a result of chronic inflammation. It may be necessary if the polyp is causing pain, discharge, or hearing loss.

You should see an ENT expert, sometimes referred to as an otolaryngologist, for the diagnosis and treatment of otitis externa. Otitis externa is one of the many disorders that ENT professionals are trained to identify and treat.

Otitis externa may be treated with drugs from a variety of types, including:

• Antibiotics: To treat bacterial infections, these are used. Common antibiotics used for otitis externa include ciprofloxacin, neomycin, and polymyxin B. These medications are often prescribed as ear drops to be applied directly to the affected ear.
• Corticosteroids: They are used to lessen pain and inflammation. Common corticosteroids used for otitis externa include hydrocortisone, dexamethasone, and prednisolone. These medications are often prescribed as ear drops, but in some cases, they may be given as a pill or injection.
• Acidifying agents: These are used to create an acidic environment in the ear canal, which can help to prevent the growth of bacteria and fungi. Common acidifying agents used for otitis externa include acetic acid and boric acid. These medications are often prescribed as ear drops.
• Antifungal agents: These are used to treat fungal infections. Common antifungal agents used for otitis externa include clotrimazole and miconazole. These drugs are often recommended as ear drops.
• Analgesics: These are used to relieve pain. Common analgesics used for otitis externa include acetaminophen and ibuprofen. These medications are often taken orally as a pill or tablet.

In general, moderate infections may cure completely in a few days to a week, although more severe cases could take longer.

It depends on the particular instance and the kind of operation. Some surgeries for otitis externa, such as a myringotomy, may provide permanent relief of symptoms. However, other surgeries, such as a tympanoplasty, may require additional procedures or ongoing treatment to maintain the results. It is crucial to go through the possible consequences and aftercare with a medical expert.

Otitis externa may be treated with drugs from a variety of types, including:

• Antibiotics: To treat bacterial infections, these are used. Common antibiotics used for otitis externa include ciprofloxacin, neomycin, and polymyxin B. These medications are often prescribed as ear drops to be applied directly to the affected ear.
• Corticosteroids: They are used to lessen pain and inflammation. Common corticosteroids used for otitis externa include hydrocortisone, dexamethasone, and prednisolone. These medications are often prescribed as ear drops, but in some cases, they may be given as a pill or injection.
• Acidifying agents: These are used to create an acidic environment in the ear canal, which can help to prevent the growth of bacteria and fungi. Common acidifying agents used for otitis externa include acetic acid and boric acid. These medications are often prescribed as ear drops.
• Antifungal agents: These are used to treat fungal infections. Common antifungal agents used for otitis externa include clotrimazole and miconazole. These drugs are often recommended as ear drops.
• Analgesics: These are used to relieve pain. Common analgesics used for otitis externa include acetaminophen and ibuprofen. These medications are often taken orally as a pill or tablet.

On average, the cost of ear drops or antibiotics prescribed for the treatment of otitis externa in India can range from INR 100 to INR 500 depending on the brand and dosage. Corticosteroid ear drops may be slightly more expensive, ranging from ₹200 to ₹800. Nevertheless, depending on the location and area within India, the cost of therapy may also vary significantly. It is always best to consult a healthcare provider or hospital for more accurate and up-to-date pricing information

Here are some potential side effects of common treatments for otitis externa:

• Antibiotics: Common side effects of antibiotics used to treat otitis externa include diarrhoea, nausea, vomiting, abdominal pain, and allergic reactions.
• Corticosteroids: Common side effects of corticosteroids used to treat otitis externa include irritation, burning, itching, and stinging in the ear. The risk of infections or other problems may also rise with prolonged usage of corticosteroids.
• Acidifying agents: Common side effects of acidifying agents used to treat otitis externa include stinging, burning, and irritation in the ear.
• Antifungal agents: Common side effects of antifungal agents used to treat otitis externa include itching, redness, and irritation in the ear.
• Analgesics: Common side effects of analgesics used to treat otitis externa include upset stomach, nausea, and drowsiness.