Introduction
In general, inflammation of the ears in humans and animals is called otitis. There are different forms of otitis, which differ in their localization. The two major subgroups of otitis are otitis media and otitis externa, which will be explained in more detail below with regard to their causes, symptoms and therapy.
Heart Canal Inflammation
Synonyms: otitis externa, “external ear infection” in animals: Otitis externa classification according to ICD- 10: H60 Otitis externa Definition: Otitis externa is an inflammation of the skin and subcutaneous fatty tissue (subcutis) in the area of the outer ear. This includes the external auditory canal (external acoustic meatus) and the pinna. This inflammation of the auditory canal is triggered by allergies and microorganisms.
Otitis externa can take different forms. The following is a list of the different types of inflammation. Synonyms: Otitis externa necroticans, osteomyelitis of the temporal bone; English: malignant otitis externa (MOE) Definition: This otitis is an inflammation with a severe course of disease.
It is a necrotizing inflammation that can spread to the cranial bones and the cranial nerves and damage them. Necrotizing means that the tissue dies off in an inflammatory way. Cause: Such an otitis is the result of an infection of the external auditory canal, especially with the pathogen Pseudomonas aeruginosa.
Immunocompromised patients are usually affected. Symptoms: A necrotizing otitis manifests itself in severe pain of the affected person. A secretion from the external auditory canal occurs.
Fluid leaks from the ear. In the course of the disease, the inflammation spreads to the cranial nerves. A very prominent symptom is facial nerve paresis.
This damage to the so-called facial nerve is manifested as a disturbance of the patient’s facial expression. Other cranial nerves can also be affected. With this otitis, the affected persons are generally not well.
They are plagued by severe pain and a general weakness. Diagnosis: Elevated inflammation values (for example CRP) are detectable in the blood. Further diagnostics include magnetic resonance imaging, computed tomography and a bone scintigram.
By means of a test excision it is ensured that it is not a carcinoma, i.e. a malignant tumor. Here, a little inflamed tissue is removed and pathologically examined. Therapy: The therapy of otitis externa maligna depends on the severity of the course of the disease.
First of all, the external auditory canal is cleaned daily. The inflammation is treated with antibiotics. On the one hand, these are applied locally, i.e. they are applied to the inflamed area, and on the other hand they are administered systemically.
The duration of the therapy varies between 6 weeks and 6 months, but can last up to a year in case of a very severe course of the disease. Since small bone parts, so-called bone sequestersers, can be damaged and detached, surgical removal may be necessary. Abscesses on the ear are surgically opened and cleaned.
During the therapy, the inflammation values, for example the CRP, should be checked again and again. This ensures the success of the therapy. Since in such a disease the tissue ultimately dies (necrotizes) due to oxygen deficiency (hypoxia), oxygen therapy can be considered if the disease is resistant to therapy.
In this way the dying tissue is supplied with oxygen. The oxygen is usually administered by means of a nasal probe. In extreme cases, it may be necessary to surgically remove the destroyed bone area or at least parts of it.
Synonyms Auditory canal phlegmons, auditory canal eczema; English: diffuse otitis externa Definition Otitis externa diffusa, also called auditory canal phlegmons or auditory canal eczema, is an inflammation of the skin and subcutaneous fatty tissue (subcutis) of the external auditory canal. A distinction is made between a dry form and a weeping form, which differ in their clinical symptoms. Causes This form of otitis is usually caused by an infection with bacteria or fungi.
The most common pathogens are Pseudomonas aeruginosa, Staphylococcus aureus and Proteus. An allergy, for example to cosmetics or hair shampoo, is also a cause of ear canal eczema. The external auditory canal becomes susceptible to the penetration of such pathogens primarily by cleaning the ears with cotton swabs or the finger.
Further risk factors are metabolic diseases, such as diabetes mellitus, or chronic otitis media.Symptoms: Dry form: The auditory canal eczema manifests itself in a flaking of the skin and unpleasant itching (pruritus). Weeping form: This form of otitis externa diffusa is called weeping because a secretion escapes from the ear. These secretions are greasy and are also known as foetal.
This means that they smell foul. The unpleasant smell is caused by bacterial decomposition products, which are sulfur compounds. Secretions from the middle ear are more slimy than greasy, which makes it possible to differentiate between them.
Other symptoms are severe ear pain, which increases when pressure is applied to the tragus. Externally, one can see a swelling of the auditory canal. This swelling is accompanied by severe itching.
The eardrum can also be affected by an inflammation (myringitis). The pre-auricular lymph nodes (located around the auricle) are swollen and painful. Diagnosis: Clinical examination and evaluation of the symptoms provides the final diagnosis.
Swabs are taken to determine the causative germ. A suitable antibiotic can then be prescribed. Furthermore, the patient is examined for allergies.
Finally, an examination of the eardrum is carried out, as it may also be affected. Therapy: Dry form: The eczema is treated with the help of Cortison ointments. For the treatment of tears (rhagades) silver nitrate solution (5%) is used to etch them.
Weeping form: First, the external auditory canal is cleaned, followed by a local application of antibiotics. This is of course only done in case of bacterial infection. The antibiotics are applied in ointments or drops and only in very rare cases is systemic administration used.
An irrigation of the auditory canal can be performed. In case of a fungal infection, antimycotic ointments or creams are applied to the external auditory canal in the form of sticks in the ear canal. Synonyms: Auditory canal furuncle; English: meatal furuncle, circumscribed otitis externa Definition: This extremely painful inflammation is an inflamed hair follicle in the external auditory canal; it is also called auditory canal furuncle.
Causes: Bacterial infections are often the cause of such an inflammation of the hair follicles. The penetration of the germs, often staphylococci, is promoted by cleaning the ears or scratching. Here a metabolic disease, like diabetes mellitus, is also a risk factor for the frequent occurrence of such ear canal furuncles.
Symptoms: Externally, the preauricular and retroauricular (around and behind the auricle) lymph nodes are seen as enlarged. A swelling of the external auditory canal is visible. The clinical examination of the auditory canal by means of an ear funnel is painful.
The existing, strong pain is intensified by pressure on the tragus and chewing. Diagnosis: The clinical examination of the patient provides the diagnosis. Therapy: For treatment, alcohol compresses and strips of gauze soaked with alcohol are placed in the ear.
Painkillers (analgesics) are prescribed for the strong pain. Ointments containing cortisone and antibiotics are also used for therapy. Synonym: Influenza otitis Definition: This otitis can occur in the context of influenza (influenza and other viral infections).
However, it occurs more frequently in cases of inflammation of the middle ear (otitis media) and acute inflammation of the eardrum. Causes: The causes are viral pathogens. symptoms: The symptoms include earache and conductive hearing loss.
Bloody blisters are also visible in the ear canal and on the eardrum. Rarely is such an otitis associated with tinnitus or dizziness. This occurs especially when the inner ear is also affected.
This can lead to hearing loss. Diagnosis: The two methods used for diagnosis are otoscopy and the tone threshold audiogram. An otoscopy is an examination of the external auditory canal and the eardrum using an otoscope.
The tone threshold audiogram is used to test the competence of the hearing. Therapy: The treatment is initially performed using a tympanic tube. This serves to ventilate the tympanic cavity and the eardrum.
Infusion therapy can also be prescribed. In every form of otitis externa there is a certain risk that the infection will spread to the surrounding bones and soft tissues, as well as to the cranial nerves. Bone marrow inflammation and cranial nerve loss are particularly dangerous in this case.
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