What is swimmer’s ear and how does it develop. What are the common symptoms of swimmer’s ear. How can you prevent and treat swimmer’s ear at home. When should you seek medical attention for swimmer’s ear.

Understanding Swimmer’s Ear: An Overview

Swimmer’s ear, medically known as otitis externa, is a common condition affecting the outer ear canal. Despite its name, this ailment isn’t exclusive to swimmers. It’s an irritation, swelling, or infection that can affect anyone, though it’s particularly prevalent among children and young adults who spend a lot of time in water.

The outer ear canal provides an ideal environment for bacterial and fungal growth, being warm and dark. When water becomes trapped in this area, it creates perfect conditions for these microorganisms to thrive, leading to infection.

How does swimmer’s ear differ from other ear infections?

Unlike middle or inner ear infections, swimmer’s ear specifically affects the outer ear canal. This distinction is crucial for proper diagnosis and treatment. While inner ear infections often require oral antibiotics, swimmer’s ear is typically treated with topical medications.

Recognizing the Symptoms of Swimmer’s Ear

Identifying swimmer’s ear early can lead to quicker treatment and relief. The symptoms can range from mild discomfort to severe pain. Here are the key signs to watch for:

• Pain or itching in the ear canal
• A sensation of fullness or blockage in the ear
• Temporary hearing loss or muffled hearing
• Clear or pus-like drainage from the ear
• Swelling of the outer ear, which may be painful to touch
• Redness and scaling of the ear canal

In severe cases, the infection can spread beyond the ear canal, potentially affecting the skull bone. This is particularly concerning for older individuals and those with diabetes, as they may be more susceptible to complications.

When do symptoms typically appear?

Symptoms of swimmer’s ear often develop rapidly, sometimes within a day or two after exposure to water or other irritants. The onset can be sudden, catching many people off guard.

Common Causes and Risk Factors for Swimmer’s Ear

While swimming is a primary cause, it’s not the only culprit. Understanding the various factors that can lead to swimmer’s ear is crucial for prevention. Here are some common causes:

1. Prolonged exposure to water, especially in unclean swimming areas
2. Excessive cleaning of the ears, which can remove protective earwax
3. Injury to the ear canal from objects like cotton swabs or fingernails
4. Skin conditions such as eczema or psoriasis that affect the ear canal
5. Trapped water from frequent swimming or showering
6. Chemical irritants like hairspray or hair dye entering the ear canal

Are some people more prone to swimmer’s ear?

Yes, certain individuals may be more susceptible to developing swimmer’s ear. Those with narrow ear canals, recurring skin conditions affecting the ears, or a history of excessive earwax production may be at higher risk. Additionally, people who swim frequently or participate in water sports are more likely to experience this condition.

Diagnosing Swimmer’s Ear: What to Expect

If you suspect you have swimmer’s ear, consulting a healthcare professional is crucial for accurate diagnosis and appropriate treatment. Here’s what you can expect during a typical diagnostic process:

• Visual examination: Your doctor will look inside your ear using an otoscope. The infected ear may appear red, swollen, or scaly.
• Physical assessment: Touching or moving the outer ear may cause pain, which is a key indicator of swimmer’s ear.
• Eardrum check: The doctor will examine your eardrum for signs of infection or perforation, though swelling may sometimes obstruct the view.
• Sample collection: In some cases, a sample of fluid from the ear may be taken and sent to a laboratory to identify the specific bacteria or fungus causing the infection.

How is swimmer’s ear distinguished from other ear conditions?

Swimmer’s ear is primarily differentiated from other ear conditions by its location in the outer ear canal and its associated symptoms. Unlike middle ear infections, which affect the area behind the eardrum, swimmer’s ear symptoms are more localized to the outer ear and canal. The presence of pain when touching the outer ear or pulling on the earlobe is often a telltale sign of swimmer’s ear.

Effective Prevention Strategies for Swimmer’s Ear

Prevention is key when it comes to swimmer’s ear. By following these strategies, you can significantly reduce your risk of developing this uncomfortable condition:

1. Keep ears dry: After swimming or bathing, thoroughly dry your ears. Tilt your head to each side to allow water to drain out.
2. Use earplugs: When swimming, consider wearing waterproof earplugs or a tight-fitting swim cap.
3. Avoid inserting objects: Never insert fingers, cotton swabs, or any other objects into your ear canal.
4. Protect your ears: When using hair products, cover your ears to prevent chemicals from entering the ear canal.
5. Maintain ear health: If you have skin conditions like eczema, manage them properly to reduce the risk of ear canal inflammation.

Is it safe to use preventive ear drops?

Yes, some people find success in using preventive ear drops after swimming. A simple homemade solution of equal parts white vinegar and rubbing alcohol can help prevent bacterial growth and facilitate water evaporation in the ear canal. However, it’s important to consult with a healthcare provider before using any ear drops, especially if you have ear tubes or a perforated eardrum.

Home Remedies and Treatment Options for Swimmer’s Ear

While severe cases of swimmer’s ear require medical attention, there are several home remedies and over-the-counter treatments that can provide relief for mild cases:

• Heat application: A warm compress held against the ear can help alleviate pain.
• Over-the-counter pain relievers: Acetaminophen or ibuprofen can help manage pain and reduce inflammation.
• Vinegar and alcohol drops: As mentioned earlier, this mixture can help restore the ear’s normal pH and hinder bacterial growth.
• Keep the ear dry: Avoid swimming and protect your ear while showering until symptoms improve.
• Gentle cleaning: If prescribed by a doctor, carefully clean the outer ear with a soft cloth.

How long does it take for swimmer’s ear to heal with home treatment?

With proper care and treatment, mild cases of swimmer’s ear often show improvement within 3-7 days. However, complete resolution may take up to two weeks. If symptoms persist or worsen after a few days of home treatment, it’s essential to seek medical attention.

When to Seek Medical Attention for Swimmer’s Ear

While many cases of swimmer’s ear can be managed at home, there are situations where professional medical care is necessary. Be alert for the following signs that indicate you should see a doctor:

• Severe pain or pain that doesn’t improve with over-the-counter pain relievers
• Symptoms that persist for more than a week
• Fever above 101°F (38.3°C)
• Swelling or redness that spreads beyond the ear
• Hearing loss or ringing in the ears
• Pus or foul-smelling drainage from the ear

For individuals with diabetes or weakened immune systems, it’s particularly important to seek prompt medical attention for any ear symptoms, as they are at higher risk for complications.

What treatments might a doctor prescribe?

When home remedies aren’t sufficient, a doctor may prescribe:
– Antibiotic ear drops to fight bacterial infections
– Antifungal medications if a fungal infection is present
– Oral antibiotics for severe infections
– Steroid drops to reduce inflammation and swelling
– Prescription pain medication for severe discomfort

Your doctor will also likely recommend keeping the ear dry during the treatment period, which typically lasts 7-10 days.

Long-Term Implications and Management of Recurring Swimmer’s Ear

For most people, swimmer’s ear is a one-time occurrence that resolves completely with proper treatment. However, some individuals may experience recurrent episodes, especially if they’re frequent swimmers or have anatomical factors that predispose them to the condition.

Long-term management strategies for those prone to swimmer’s ear include:

• Regular use of preventive measures, such as drying ears thoroughly after water exposure
• Using custom-fitted earplugs for swimming
• Avoiding irritants like hair products near the ears
• Managing underlying skin conditions that may contribute to ear canal inflammation
• Regular check-ups with an ENT (ear, nose, and throat) specialist for those with frequent recurrences

Can swimmer’s ear cause permanent damage?

In most cases, swimmer’s ear does not cause permanent damage when treated promptly and properly. However, rare complications can occur, particularly in severe or untreated cases. These may include:
– Temporary hearing loss that usually resolves as the infection clears
– Chronic outer ear infection, which can lead to persistent pain and discharge
– Narrowing of the ear canal due to chronic inflammation
– In extremely rare cases, the infection can spread to nearby tissues, potentially affecting the skull bone or brain

These severe complications are uncommon and can usually be prevented with timely treatment and proper care.

Understanding swimmer’s ear, its causes, symptoms, and treatment options empowers individuals to take proactive steps in prevention and early intervention. By maintaining good ear hygiene, being mindful of water exposure, and seeking timely medical attention when necessary, most people can effectively manage and prevent this common condition. Remember, your ears play a crucial role in your overall health and quality of life, so don’t hesitate to care for them with the attention they deserve.

Otitis Externa – What To Do For Swimmers Ear

What is swimmer’s ear?

Swimmer’s ear is an irritation, swelling, or infection in your ear. It’s often caused by swimming a lot or swimming in unclean water. It can occur suddenly. It’s common in children and young adults but can happen to anybody. The medical name for swimmer’s ear is otitis externa.

Swimmer’s ear infects the outer ear or ear canal. Because those areas are dark and warm, bacteria and fungus can grow there to create an infection. Note this type of infection is different than an inner ear infection.

Symptoms of swimmer’s ear

There are many symptoms of swimmer’s ear, including:

• Pain and/or itching
• A plugged-up feeling in the affected ear
• Some hearing loss
• Clear or pus-like drainage
• Swelling inside the ear and painful to the touch

In serious cases, swimmer’s ear can spread to other areas of the ear. This includes the skull bone. The infection can become severe in older people and people who have diabetes.

What causes swimmer’s ear?

Several things can cause swimmer’s ear, including:

• Swimming in unclean water.
• Swimming and showering too much. Water can accumulate in the ear canal, which allows germs to grow.
• Excessive cleaning of your ears. Earwax helps to flush germs from the ear. Removing too much may allow germs to spread and start an infection.
• Injuring the skin in the ear canal. This can happen by putting your finger or an object (such as a cotton swab) in your ear.
• Some skin conditions. If you have conditions such as eczema and psoriasis in other places on your body, they can occur in the ear canal, too. This can cause an infection.
• Bacteria from products used in your hair, such as hairspray or hair dye. These products can get trapped in your ear canal.

How is swimmer’s ear diagnosed?

Your doctor will look inside your ears. As they do, touching or moving it may hurt. The infected ear will appear red and swollen. It also may look scaly. Your doctor will check your eardrum for infection or a hole. They may not be able to see the eardrum due to swelling.

Your doctor may take a sample of fluid from the ear to send to a lab. The lab is checking for bacteria or fungus.

Can swimmer’s ear be prevented or avoided?

Follow these tips to prevent swimmer’s ear:

• Never put anything in the ear canal. This includes cotton swabs, your finger, liquids, sprays, etc. If your ears itch, see your doctor.
• Don’t remove earwax on your own. If you think your earwax affects your hearing, see your doctor.
• Take steps while in the water. When swimming, wear a bathing cap or wet suit hood. Special earplugs can keep water out of your ears.
• Keep your ears dry. Use a towel to dry your ears after swimming or showering. Let the water run out of your ears. Turn your head to each side and pull the earlobe in different directions to let the water drain out. You also can use a hair dryer set on the low heat to dry your ears. Hold the dryer several inches from your ear.
• Try to avoid bacteria. To help prevent bacteria from growing in your ear, mix one drop of rubbing alcohol with one drop of white vinegar. Place the drops of the mixture into the ears after they get wet.

Swimmer’s ear treatment

Your doctor will clean the drainage or pus from your ear. They will likely prescribe antibiotic ear drops to make your infection go away and may prescribe oral antibiotics if your case is severe. They may also prescribe other medicine to help with itching. Over-the-counter medicine can relieve pain. Ask your doctor what type you should take.

After your diagnosis, keep your ear as dry as possible for 7 to 10 days. Take baths instead of showers. Put a cotton ball in each ear to keep the water out. And don’t swim during that time. Your symptoms should be better in 3 days. They should go away in 10 days.

Living with swimmer’s ear

Swimmer’s ear usually isn’t serious if it’s treated early. Most symptoms will go away as the infection clears up. In rare cases, the infection can spread and cause damage to skin tissue, bone, and cartilage. Older adults, people with diabetes or weakened immune systems are most at risk for more widespread infection.

Questions to ask your doctor

• Can I get swimmer’s ear from chlorinated pool water?
• How much swimming is too much swimming?
• Am I more likely to get swimmer’s ear if I have small eustachian tubes?
• Should my baby wear ear plugs in the bath and in pools? Are those safe?
• Can repeated infections cause serious hearing loss?
• Can I get swimmer’s ear from taking showers?

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Otitis Externa (Swimmer’s Ear): Causes, Symptoms and Treatment

Nationwide Children’s Hospital

“Swimmer’s ear”, also called otitis externa (oh TIE tis  ex TER nuh), is an infection of the skin in the outer ear canal.  This is the area from the eardrum to the outside of the ear (Picture 1).  It is called “swimmer’s ear” because it often occurs when water stays in the ear canal and it is usually caused by bacteria or fungus found in swimming pools, lakes and rivers.  Because the ear canal is dark and warm, bacteria and fungus can easily grow.

Causes of Swimmer’s Ear

• Swimming or playing in water including lakes or ponds, as well as swimming in pools with chlorine
• Cleaning your child’s ears (can remove the protective layer of wax in the ear canals and cause small scratches, making him or her more prone to infection)
• Skin allergies and eczema
• Injury to the skin in the ear canal 

Symptoms of Swimmer’s Ear

• Pain, which can be severe, when the ear is touched or moved or with chewing
• Reddened or swollen outer ear or ear canal opening
• Itching or dull pain in the ear
• Plugged feeling in the ear 
• Ear drainage
• Fever
• Muffled hearing for a short time

Treatment

Your child’s doctor will examine your child’s ears and gently clean them.

• An antibiotic (an ti by AH tik) ear medicine, typically a topical ear drop, may be prescribed to fight the infection and lessen itching and swelling.
• You may be taught how to suction drainage from your child’s ear before putting the ear drops in.
• An ear wick (a small sponge that stays in the ear and hold the ear drops against the skin) may be necessary – your doctor or nurse will explain this to you.
• Treat pain with over-the-counter pain relievers, such as Tylenol® or ibuprofen. 

How to use Warm Compresses

Warm compresses (packs) may help to ease the pain.  To use the warm compresses:

1. Wet a folded washcloth in comfortably warm (not hot) water, and wring out the excess water.
2. Have your child hold the warm washcloth over the ear several times a day for 10 to 15 minutes each time. The best times may be before school, after school, after dinner, 
   and at bedtime.
3. When the compress cools, wet the washcloth again with warm water.   You will probably need to wet the washcloth 3 or 4 times during a 15-minute treatment.
4. Use a clean washcloth every day.  Launder the washcloth before it is used again.

Activity

• Keep the ear as dry as possible for 7 to 10 days.
• Dry your child’s ears well after swimming or showering.
• To help prevent Otitis Externa, use a mixture of half rubbing alcohol and half white vinegar to dry the ears after your child swims. Put three to four drops of the mixture in each ear. Do not do this if your child has ear tubes or a hole in his ear drum.
• A hair dryer on the coolest setting can be used to dry the ear.  Hold the dryer four to six inches from the ear.
• Your child should avoid swimming until the ear is completely pain-free.  Check with your child’s doctor or nurse before he or she goes swimming. Avoid showers or try to keep water out of the ear during showering using a cotton ball coated in ointment in the outer ear.
• Your child should never put anything in the ear that can injure or scratch the canal.
• Ask your child’s healthcare provider about wearing earplugs for swimming. 

Medicine Storage and Safety

• Store all medicine out of children’s reach.  
• Keep a list of what medicines your child takes and when and why they are taken.
• Always keep medicine in the labeled container it came in.
• Do not use this medicine after the expiration date printed on the container.
• Do not stop giving this medicine or change the amount given without first talking with your child’s doctor.
• Do not give this medicine to anyone other than the child for whom it was prescribed.
• If your child sees a new doctor or goes to an emergency room, be sure to tell them about all the medicines your child is taking.
• Your child’s school will need a note from you and the doctor if this medicine is to be given at school by the school nurse.

When to Call the Doctor

Call your child’s doctor if he or she has any of the following:

• Pain that is not eased by eardrops or heat or that lasts more than 2 days
• Any discharge or drainage from the ear
• Redness or swelling of the outer ear or behind the earlobe
• Temperature over 101°F by mouth or 102°F under the arm
• Any problems with taking the medicine

If you have any questions, be sure to ask your child’s doctor or nurse.

Ear: Otitis Externa (Swimmer’s Ear) (PDF)

HH-I-223 2/03, Revised 3/19 | Copyright 2003, Nationwide Children’s Hospital

“Swimmer’s ear”: what is it and how to treat :: News :: TV Center

Doctors insist that sudden immersion in ice water can even be life-threatening. In cold or icy water, you need to go gradually so that the body has time to adapt to a decrease in temperature. What is “swimmer’s otitis” and what symptoms should immediately contact a specialist – otorhinolaryngologist Alexei Borodin told in an interview with TV Center.

– Otitis or swimmer’s ear is a kind of collective image of the disease. Please tell us in more detail what kind of diagnosis it is.

– Otitis or swimmer’s ear is a disease in which an infection, usually with water, enters the ear canal, causing inflammation of the very thin and delicate skin of the ear canal. As a rule, those who swim a lot, as the name implies, lovers of baths and saunas, tourists visiting hot climates, tend to have this disease, because when it’s hot and humid, the conditions for this infection are better.

– That is, the pathological main link there is water stagnation. And where is the infectious factor? Because it is usually the main condition for the development of inflammation.

– Water is non-sterile both in natural reservoirs and in pools. And by the way, this disease has a seasonality. Usually it happens more often in the second half of summer, in August – early September, when during the long swimming season, while infections, bacteria multiply, their concentration increases, and, accordingly, they cause inflammation more easily. And the infection that most often causes this inflammation – that is, theoretically it can cause any – but most often it is either Pseudomonas aeruginosa or Staphylococcus aureus, in the vast majority of cases.

– This disease, like many others, has several stages of development. Let’s talk about this in more detail.

– At a mild stage, inflammation begins simply in the skin of the ear canal. If timely measures are not taken, the infection develops and affects more and more surface of the ear canal. In severe cases, it spreads to the auricle, and deep into the eardrum, the symptoms intensify.

– That’s just about the symptoms. When the initial stage of inflammation, the first stage, is not yet severe, what symptoms bother a person?

– First of all, it’s pain. The simplest and most obvious symptom. The skin is very thin and very delicate in the ear canal, and under it there is almost no soft layer, just bone. Therefore, the skin begins to hurt immediately. It is very characteristic that pain increases when the tragus is pressed and when the lower jaw moves, since the joint of the lower jaw is also close to the lower wall of the auditory canal. From the inside, of course, yes. With the development of inflammation, complaints of hearing loss, a feeling of congestion and swelling inside can be added. There is itching, discharge from the ear.

– And let’s go back to the moment when the water did get into our ear. After all, there is a famous folk way – to jump on one leg, all this seems to be pouring out with us, and that’s it.

– If it pours out, then great. There is another good way – this is to take a hair dryer, for example, if there is usually one in a hotel or at home, turn it on to the lowest temperature so that it is not hot air, but blows strongly, and try to dry your ear with a hair dryer. The main thing is not to put anything in the ear inside, trying to dry it.

– What treatment of otitis media do otorhinolaryngologists prescribe?

– First of all, the doctor will look at the ear, if necessary, he will clean it. The doctor can take an analysis – sowing on the microflora to clarify which pathogen, but treatment is usually prescribed immediately. If this is not a severe form, then these will be drops in the ear, based on statistics, that is, the means are chosen that best help against the most common pathogens. If in the future it turns out that the treatment needs to be changed, then it will already be possible to use the results of the analysis that was taken at the first meeting.

– Is it possible to somehow prevent the appearance of this very otitis? Maybe plug earplugs into your ears all the time before you go somewhere in the reservoir?

– In my opinion, it is rational to use them only if a person already knows that he has a tendency to swimmer’s otitis, that it is very easy for him to catch it. Then, of course, you can use earplugs. Before, for example, going on vacation or going to the pool, you can look in advance at the otolaryngologist and make sure that there is no sulfur plug, a sulfur accumulation that provokes. That is, take action.

– The ear is a very delicate organ. And there are people who quite intensively clean every day with ear sticks, sticking them deeper. What can you say about the correct and recommended ear toilet?

– Thanks for this question, it’s a sore subject. The fact is that earwax is not just produced in the ear. Due to its chemical composition, it prevents the growth of bacteria in the ear. By removing this sulfur, we remove this powerful protective factor for our ear canal, and secondly, we can very easily injure the ear canal. The third option – we can bring the infection by removing the sulfur. After all, for example, the same cotton swabs are non-sterile.

– We can push the infection there.

– That’s right. Push the infection and tamp the sulfur only deeper. It’s one thing when sulfur is here at the entrance, it’s difficult to get it, for example, but with a cotton swab, trying to clean it, we can push it, tamp it closer to the eardrum, and then even without any water, inflammation can develop, and the ENT -The doctor will be a very difficult task to help.

– The ear toilet must therefore be limited to the external auditory canal only.

– Only at the entrance. The rule is this: where we see, we can wipe, where we do not see, we do not climb with anything. From the interesting – cotton buds were not invented for the ears.

– Why?

– To remove makeup. In order for babies to clean between the fingers and the navel. And if you take any package of cotton buds, it will say in very small print: “Do not put in your ears.”

Based on the materials of the program “Doctor I…” on the channel “TV Center”.

All the most interesting – in our channel “Zen”

Swimmer’s ear – causes, symptoms, diagnosis and treatment

Swimmer’s ear is a disease of the external acoustic canal, characterized by diffuse inflammation of the skin of its walls, possible damage to the tympanic membrane and auricle, usually caused by water entering the ear. It is manifested by otalgia, otorrhea, a feeling of congestion, hearing loss, fever. The diagnosis is established on the basis of examination, otoscopy, laboratory tests. Prescribed conservative treatment with antibacterial, antifungal, steroid and non-steroidal anti-inflammatory drugs. If necessary, surgical operations are performed.

General information

Swimmer’s ear (swimmer’s ear syndrome, diffuse otitis externa) is a ubiquitous disease, somewhat more common in regions with a hot climate. May be acute or chronic. The incidence is 17-30% of all ear diseases. Swimmer’s otitis is observed in 1 case per 100-250 people per year. Chronic inflammation occurs in 3-5% of patients. In 90% of cases, the chronic form of diffuse external otitis develops in patients with diabetes mellitus. Men and women are equally affected. The disease is detected at any age, but children and young adults are more susceptible to this pathology.

Swimmer’s ear

Causes

The causative agents are predominantly bacteria. In the vast majority of cases, Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus aureus, Streptococcus, and other pathogenic and conditionally pathogenic microorganisms become the direct cause of otitis externa. Less often, the disease is caused by fungi, among which representatives of the genera Aspergillus and Candida predominate, very rarely – viruses. In recent years, there has been an increase in otitis media of mixed etiology (provoked by microbial associations, bacterial-viral).

Swimmer’s otitis often manifests after getting water in the ear, visiting a steam room, and a period of stay in a region with a humid and hot climate. The risk group includes athletes involved in swimming, diving or rowing, lovers of swimming in open water and pools. An important prerequisite for the development of the inflammatory process is the constant mechanical traumatization of the ear canal with aggressive toileting of the ears, regular use of headphones, and wearing a hearing aid. Risk factors also include skin diseases of the outer ear, abnormal narrowing of the auditory canal.

Pathogenesis

The outer ear is protected from infection by mildly acidic earwax. It contains lysozyme, which destroys the bacterial wall, thereby inhibiting the reproduction and spread of pathogens. Water that gets into the ear inactivates the acidic environment, traumatizing the skin of the ear canal leads to a violation of the production of earwax. Bacteria or fungi multiply freely, causing an inflammatory response from the skin of the outer ear. With a pronounced decrease in immunity, the pathology spreads to the auricle, regional lymph nodes, affects the soft tissues of the face and neck, and the temporal bone.

Classification

Swimmer’s ear is classified by etiological factor. A separate nosological group includes otomycosis – fungal lesions of the skin of the external auditory canal. In addition, there is a severe form of this pathological process that occurs in immunocompromised individuals – necrotizing otitis media. By localization, the disease is right-, left- and bilateral. Taking into account the clinical course of the disease, the following variants of swimmer’s otitis are distinguished:

• Spicy. Characterized by an acute onset, complete recovery within 4-6 weeks.
• Chronic. Is the outcome of an acute process or initially proceeds sluggishly as a primary chronic pathology. Symptoms of the disease persist for longer than 6-12 weeks.

Symptoms of swimmer’s otitis

Acute processes manifest as pain in the ear area. The pain can be pulsating in nature, radiate to the upper and lower jaws, the temporal region, and the neck. Varies in intensity, increases with pressure on the ear or pulling it by the lobe, chewing movements and opening the mouth. Otalgia is accompanied by a feeling of fullness, congestion, hearing is reduced. Attention is drawn to the redness of the skin in the area of ​​​​the mouth of the acoustic channel, sometimes in the cartilaginous part of the auricle.

One of the main signs of diffuse otitis externa is discharge from the ear. Their color and texture depend on the pathogen that caused the disease. Swimmer’s ear is sometimes accompanied by subfebrile, rarely febrile fever. The general condition with uncomplicated otitis media suffers little. Symptoms of intoxication are rarely present. Sometimes there is an increase in the parotid lymph nodes. The chronic inflammatory process of the outer ear proceeds sluggishly, the clinical signs are less pronounced. Often the main symptom of the disease is itching in the ear canal.

Complications

The most severe complication of this pathology is malignant necrotizing otitis media. It occurs rarely, mainly in patients with diabetes mellitus, persons with severe immunodeficiency. With this complication, the inflammatory process extends to deeper tissues. Osteomyelitis of the temporal bone and skull base develops, which leads to meningitis and meningoencephalitis. Without treatment, about 50% of patients with necrotizing otitis die.

Pseudomonas aeruginosa inflammation often affects the ear cartilage. Chondroperichonditis occurs, leading to purulent fusion of the cartilage and deformation of the auricle. The pathological process may involve soft tissues of the neck and face, parotid lymph nodes, salivary glands. In chronic external diffuse otitis often there are signs of myringitis, perforation of the eardrum.

Diagnosis

Patients with otitis externa are examined by an otorhinolaryngologist. When collecting an anamnesis, the possibility of systematic ingress of fluid into the ear, the presence of endocrinological and skin diseases, and the immune status are clarified. Examination reveals skin hyperemia, edema and narrowing of the acoustic channel, the presence of pathological discharge, signs of regional lymphadenitis. On palpation of the tragus, there is an increase in pain. The final diagnosis is confirmed by the results of the following studies:

• Imaging techniques. Otoskopiya, otomikroscopy allow to visually assess the condition of the walls of the ear canal, the tympanic membrane, to conduct a differential diagnosis of swimmer’s otitis media with pathology of the middle ear. With a significant narrowing of the channel, the study is carried out using endoscopic equipment. Under the control of otoscopy, pathological material is taken.
• Laboratory studies. When analyzing peripheral blood, leukocytosis can be detected with a shift of the leukocyte formula to the left, acceleration of ESR. The determination of blood glucose is prescribed to exclude diabetes mellitus, an HIV test is prescribed to assess the immune status. A bacterioscopic and bacteriological study of pathological discharge from the ear is carried out, the sensitivity of pathogenic microflora to antibiotics is clarified.

In unclear cases, an ear biopsy may be ordered. To exclude malignant neoplasms of the auditory canal, consultation with an oncologist is sometimes required. If necrotizing otitis is suspected, x-ray, CT or MRI of the temporal bone is performed. With a significant decrease in hearing, audiometry, a tuning fork study is performed.

Treatment of swimmer’s otitis

The choice of treatment tactics depends on the general and immune status of the patient, the presence of myringitis, lymphadenitis and other complications. Patients with an uncomplicated course of the disease are prescribed conservative outpatient treatment. Patients with malignant necrotizing otitis need hospitalization in the department of otorhinolaryngology. If necessary, surgical intervention is performed.

Conservative therapy

Therapeutic measures begin with the cleansing of the acoustic channel from pathological masses formed by sulfur, desquamated epidermis and secretions, using turunda. Then the ear is washed with warm water or a weak antiseptic solution, and dried. Pharmacotherapy is prescribed, which is complemented by thermal physiotherapy procedures. Depending on the action, the following groups of drugs are used:

• Etiotropic. The list of medicines is determined taking into account the inoculated microflora. In uncomplicated otitis media, local agents are indicated – topical antibiotics and antimycotics in the form of creams, ointments, ear drops. Preference is given to drugs with antipseudomonal and antistaphylococcal activity – aminoglycosides, fluoroquinolones, polymyxins. Clotrimazole is used as an antifungal agent. Patients with symptoms of general intoxication and immunocompromised individuals are additionally prescribed oral or parenteral administration of systemic antibiotics.
• Pathogenetic and symptomatic. Pathogenetic therapy involves the appointment of steroid hormones. Systemic analgesics and local anesthetics are used to relieve pain. Most modern topical preparations are a combination of antibiotics and/or antimycotics with anesthetics and corticosteroid hormones.

Surgical treatment

Indications for surgical intervention are pathological narrowing of the auditory canal associated with the underlying disease, the presence of exostoses.