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Page: Otitis Externa
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Otitis externa ("swimmer's ear") is an inflammation of the outer ear and ear canal. Along with otitis media, external otitis is one of the two human conditions commonly called "earache". It also occurs in many other species. Inflammation of the skin of the ear canal is the essence of this disorder. If inflammation progresses to infection, the ear canal may fill with swollen tissue and drainage. Once the ear canal is blocked, hearing will be dampened (conductive hearing impairment) until the condition improves. In very severe cases, the skin infection can spread to the face (facial cellulitis) and to the major salivary gland in the cheek (parotitis). In that situation, moving the jaw and eating become painful. In its mildest forms, external otitis is so common that some ear nose and throat physicians have suggested that most people will have an episode at some point in life. In many individuals, for the reasons discussed below, the condition is recurrent and will happen several times in a lifetime.
Inflammation of the ear canal skin typically begins with the loss of protective oils and ear wax (cerumen) along with minor injury to the skin. That injury often stem from attempts at self-cleaning or scratching using cotton swabs, hair pins or other implements small enough to fit in the ear canal. Prolonged water exposure (either swimming or exposure to extremely high humidity) is enough alone to both decrease the protective barrier of ear wax and to cause tiny breaks in the waterlogged skin, hence the name, "swimmer's ear". Since the swollen ear canal skin often is both itchy and painful, and sometimes associated with a feeling that something is stuck in the ear, a vicious cycle of self-cleaning or scratching can perpetuate the condition. Wax glands shut down the production of protective cerumen when the canal skin is inflamed, and weeks are required for the outer ear to completely return to normal production of wax and protective oils after even a short bout of moderately severe external otitis. During this recovery period, the skin is markedly more vulnerable to becoming re-infected. For these reasons, among others, some people are prone to recurrent external otitis with exposure to water.
There is a rare and serious form of external otitis called necrotizing external otitis, in which the bone of the skull surrounding the ear canal becomes infected. Although the name of this condition contains the words "external otitis" it is a very different disease than the common swimmer's ear, it is a form of osteomyelitis . Instead of being a condition that most people are subject to, necrotizing external otitis (also called malignant otitis) is a life-threatening disorder that only affects individuals with severe diabetes and major disorders of the immune system. This rare complication of external otitis is discussed under Complications, below.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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