Otitis Externa
Otitis externa is infection in the ear canal. Previous pages have described acute otitis media, which is a middle ear infection behind the ear drum. Otitis externa is in the ear canal, on the outside of the ear drum.
Otitis externa is a very painful condition. In addition, ear discharge and hearing loss also usually occur. Often, itchiness is present too.
What cause Otitis Externa?
Otitis externa is an infection caused by bacteria. Sometimes it just happens, but there are two common factors that set if off:
1: getting water into the ears (otitis externa is also known as swimmers ear!)
2: scratching the ears (cotton buds are the usual culprit)
Treatment of Otitis Externa
Otitis externa is treated with antibiotic ear drops. To apply drops, lie your child on the side with the affected ear uppermost. Pull the ear back gently (it will be painful), then instil the drops. Ask your child to remain on the side for five minutes or so. Once they stand up, some drops may leak out and may need to be mopped up with cotton wool.
Pain is usually severe. Paracetamol and ibuprofen may be sufficient, and you can buy those from the pharmacy. You may wish to check with your pharmacist first to make sure that they are suitable for your child. Your doctor may also give additional pain killers.
If infection isn't settling, a referral to ENT may be required. ENT can perform microsuction: this means using a small hoover to suck the gunge out of the ear. Microsuction is quite noisy and can be a bit uncomfortable if the ear is already very painful. However, removal of the infected fluid is really useful to help the ear recover. If the ear canal is completely closed, the ENT doctor may also place a small piece of gauze (wick) into the ear canal: this is designed to keep the ear canal open and allow antibiotic drops better access into the ear canal.
Looking after your ears
There are also things you can do to stop infections. Make sure that your child doesn't scratch ears, and no cotton bud use. Ears clean themselves: there is no need for humans to scratch them, clean them out or flush them out with shower nozzles! The skin of the ear canal is very delicate, and any scratching can damage it and introduce infection.
Also make sure that ears are kept dry, at least until the infection settles. You may also wish to try and keep them dry in the long term to prevent other infections.
Use a bit of cotton wool (not cotton bud!), and place this into the hollow of the ear. please don't try and stick it into the ear canal, just place it into the hollow of the ear on the outside. Then smear some vaseline over the top, to waterproof it. Once done, simply throw away.
You can also but swimming plugs or get custom made ones: these work well for long-term water precautions, but are probably best not used when there is active infections (bacteria get onto the plug, then next time you use them you just introduce the bacteria back into the ear! With cotton wool it's cleaner because you just throw it away).
If you accidentally get water into the ear, or after swimming, you could also try the ears using a hair dryer. Put the drier on low heat, and hold at arm's length away from the ear. If it's too hot or too close you risk getting a burn! Pull the ear back as this opens the ear canal, then use the hair dryer to dry the ear canal. Drying this way is better than using towels or tissues which can introduce infection and scratch the delicate ear canal skin.
Using EarCalm spray can also help. This is based on acetic acid which is also in vinegar! It changes the acidity of the ear, and discourages bacterial growth.
For shampoo, using Baby Shampoo is often best. This is gentle on the ear. In addition, Baby Shampoo actually works quite well against the types of infections that can cause otitis externa.
So in the short term, definitely keep the ears dry. In the long term, to reduce the possibility of recurrence, many people still keep the ears dry, or use EarCalm and the hair dryer method after water exposure. Use the Baby Shampoo, and remember that scratching of the ear canal is strictly prohibited!