An ear canal infection, or otitis externa, is usually associated with severe ear pain. It is sometimes quite protracted, but complications rarely occur. If proper care is taken, the disease will heal without secondary damage. If the inflammation of the ear canal occurs during swimming, bathing or diving, it is also called bathing otitis.
What is ear canal inflammation?
Otoscopy can be used to examine diseases of the ear or hearing (e.g. otitis externa), foreign bodies or parasitic infestations of the external auditory canal, and complaints of the eardrum. It is usually performed by the ENT physician as the first examination for hearing problems. Otitis externa is a very common condition that involves an inflammatory reaction of the skin of the external auditory canal. Triggers of this extremely painful inflammation are not only bacteria, but also fungi or allergies. Often, the disease involves the eardrum. A typical feature at the beginning of an ear canal inflammation is itching; later on, pulling or burning pain sets in. These increase – due to the proximity of the jaw to the external auditory canal – when chewing. Pulling on the auricle or pressure on the cartilage inside the auricle known as the tragus also causes the symptoms to worsen. Sudden hearing loss, the formation of a secretion, swelling of the lymph nodes in the neck and fever are other symptoms of otitis media.
Causes
There are many causes for the occurrence of ear canal inflammation. For example, the smallest injuries to the skin of the auditory canal, which occur quickly during cleaning, can cause inflammation. The reason for this is the fact that the skin injury facilitates the penetration of bacteria or even makes it possible in the first place. Excessive cleaning of the ear with ear sticks or soapy water also has a favorable effect on the development of an ear canal infection, since the protective earwax is consistently removed here and thus cannot fulfill its function. The risk of infection is particularly high if an unclean finger rather than a cotton swab is used for cleaning. The inflammation can also be triggered by an already long-lasting middle ear infection, a zoster infection or an intolerance to certain substances. Furthermore, a visit to a swimming pool can result in an ear canal inflammation. This is to be expected at least if the water that has penetrated the ear canal cannot completely drain away again.
Symptoms, complaints and signs
An ear canal infection usually heals completely. In rare cases, however, it can turn into a chronic inflammation or lead to serious complications. Typical symptoms in most forms of ear canal inflammation are severe itching in the ear, burning pain in the ear canal, swollen ears and secretion discharge from the affected ear. The burning pain in the ear is aggravated by pulling on earlobes, pressure on the pinna, or chewing. The swollen ear canal is also red and scaly. At the same time, hearing is reduced in the swollen ear. Often the secretion flowing out of the ear forms crusts. If the disease spreads further, fever, swelling of the lymph nodes and a severe feeling of illness may also occur. In immunocompromised individuals, even fatal courses are possible. Some inflammations in the ear canals are limited to small areas in the ear. This is true, for example, in otitis externa circumscripta, where a hair follicle is inflamed in the form of a boil. The entire ear canal is affected in otitis externa diffusa. Otitis externa necroticans is a particularly malignant form of inflammation of the ear canal. In this case, inflamed tissue dies, and cranial bones and cranial nerves can also be affected by the inflammation. In the context of influenza, so-called otitis externa bullosa haemorrhagica can also occur, with the formation of bloody blisters in the ear canal, on the eardrum and in the middle ear.
Diagnosis and course
The diagnosis of otitis media by the physician is made during a physical examination. This is usually divided into a palpation and a visual examination of the auditory canal.First, the physician checks whether the pain increases when the auricle is pulled or pressure is applied to the tragus. If this is the case, it can be interpreted as a clear sign of an ear canal infection. To confirm the diagnosis, the doctor will usually still perform an otoscopy. In this way, redness, swelling or a coating of the auditory canal can be easily detected. A hearing or balance test is usually only performed if the patient complains of hearing loss. In individual cases, X-rays, a smear test, a blood count, or a special allergy test may also be ordered. Although otitis media proves to be painful and its healing process may extend over a long period of time, it is comparatively harmless: complications occur very rarely, and consequential damage is not to be expected.
Complications
An ear canal infection is a very unpleasant affair for the affected person. There is a stinging sensation in the ear that lasts for a long time. Anyone suffering from such an inflammation should not put off a visit to the doctor. Only with the help of early treatment and the right medication can serious complications be avoided. Those who leave an inflammation inside the ear without any treatment must expect increasing pain. In addition, there may be a strong pus formation, which occurs especially in the morning hours. However, those who decide early enough for treatment in such a case make a very good decision. A doctor can prescribe appropriate medication that effectively combats such an inflammation. Those who do without medical treatment must expect a considerable aggravation of the individual symptoms. For this reason, appropriate treatment is of great importance.
When should you go to the doctor?
An ear canal infection makes itself felt by a stabbing earache. If the pain is bearable, it is not necessary to see a doctor immediately. In many cases, a marked improvement can be heard after only a few days, provided strict bed rest is observed. In some cases, however, complications are to be expected, so that medical treatment becomes unavoidable. If pus formation is evident, the visit to the doctor can no longer be postponed. This is because there is a serious inflammation in the ear canal, which should be treated with medication as soon as possible. If such treatment is not given at this point, then a significant worsening of the existing complaints is to be expected. Pus production increases and pain also becomes more severe. In addition, viruses and bacteria can spread throughout the body, resulting in a general feeling of discomfort. Thus, the following applies: An ear canal inflammation should be treated by a doctor at the latest at the first appearance of pus. Thus, the inflammation can be fought quickly and effectively.
Treatment and therapy
The therapy of an ear canal inflammation consists essentially of an outpatient treatment, which relies on the application of locally acting measures. The therapy is often started with a meticulous cleaning of the auditory canal by the physician. The administration of medication basically depends on the cause of the disease. Swelling can be combated very well with ointments containing cortisone; in the case of a bacterial infection, an antibiotic is also prescribed. However, this is not effective in the case of fungal infections, in which case the prescription of an antimycotic is appropriate. A rapid improvement in the symptoms can only be ensured if the patient adopts a correspondingly careful behavior. For example, after showering or bathing, the patient should take care to keep the ear canal dry. This can easily be achieved with the aid of a hair dryer. If the pain is difficult to bear, painkillers can be administered specifically. In addition, a cooling of the ear is often perceived as pleasant in the case of an ear canal inflammation.
Outlook and prognosis
With good and timely medical care, the prognosis for ear canalitis is favorable. The administration of medication prevents the pathogens from spreading further. The inflammation gradually heals and the existing symptoms regress.Within a few weeks, the patient is normally free of symptoms. The more advanced the disease is at the start of treatment, the longer the healing process. There is also a risk of complications or permanent hearing impairment. Patients with a weakened immune system or other diseases must expect a delay in regeneration. The body’s immune system needs stronger support, which leads to a slowdown in healing. Without treatment, the risk of the disease spreading increases. The pathogens multiply and worsen the patient’s overall health. In addition, the disease may become chronic. In these cases, the affected person is threatened with pain of increasing severity and reduced hearing ability. In addition, disorders of the vestibular system may occur. These lead to problems with locomotion as well as an increase in the general risk of accidents. An early diagnosis as well as a quick start of therapy are therefore important for a good prognosis in the case of an ear canal inflammation. If the disease recurs, the prospect of recovery is also favorable.
Prevention
To most effectively prevent the occurrence of ear canal inflammation, the entry of foreign objects into the ear should be avoided. This includes cleaning with cotton swabs and other tools. Since the human ear has a self-cleaning function, the removal of earwax is simply not necessary. Also important: keep the ear dry and avoid the use of substances that cause allergies.
Aftercare
Inflammation of the ear canals may require follow-up care, otherwise serious complications may occur. Inflammation in the ear canals is characterized by stabbing pain and the formation of pus. Of course, such inflammation can occur in different degrees of severity, so that follow-up care is not always mandatory. In the case of mild to moderate inflammation of the auditory canals, this can be dispensed with. After taking anti-inflammatory medication, the complications and discomfort should subside. In this case, further visits to the doctor are not necessary. The situation is different if there is a severe inflammation in the auditory canals. In such a case, appropriate follow-up care should be provided. Even if the pain in the ear canal has subsided, further visits to the doctor should take place. In this way, a renewed flare-up of the inflammation that has already been overcome can be detected and prevented. After one to two weeks, further examinations can be discontinued. However, if further complications or pain occur, there should be no delay in going to the doctor. If regular and strict follow-up care is given, then nothing stands in the way of a full and speedy recovery. The inflammation subsides within a short period of days, so the pain will also subside quickly.
What you can do yourself
An ear canal inflammation can be treated and alleviated by the affected person himself by means of various home remedies, insofar as a visit to the doctor is not possible. However, the inflammation cannot be cured by the remedies, so a visit to the doctor should be made as soon as possible. Self-treatment can be done with clear alcohol. This should have a concentration of at least 45 percent. It is then carefully dripped into the ear canal to disinfect it. Onions can also be used well for treatment. They contain many valuable essential oils. The onion is cut into small pieces and wrapped in a cloth. Then the affected person puts the cloth with onions on the ear and leaves it to act. Instead of the onion, the affected person can also use a chamomile tea bag. This is brewed with boiling water, then drained and placed on the ear after cooling. The juice of freshly squeezed garlic and olive oil can also be used as ear drops. The oil should be lukewarm and two drops are dribbled into the ear. The garlic relieves the pain and has an anti-inflammatory effect. A poultice made of tea tree oil and warm water also serves to treat the pain. For this, twelve drops of tea tree oil are diluted in warm water, a cloth is soaked with this solution and placed on the ear.
