Inflammation of the ear canal (External Otitis)

Otitis Externa (OE) is an inflammation of the outer ear canal (external ear holes to the eardrum) with the main symptom are ear pain (otalgia), swelling, redness, and the ears feeling full or as there is pressure from the ear.

In addition to these symptoms, otitis externals can also cause the ears to itch (especially in OE because of fungi and the chronic OE), watery, the skin around the channel seemed scaly and sometimes accompanied exfoliation, hearing reduced due to stenosis or the formation of thick and dry skin in the ear canal, the appearance of acne-like texture when infection concerning hair follicles in the ear. Otitis externa usually affects one ear only.

The risk factors that simplify otitis externa are the pH changes in the ear canal, which are usually normal or acidic. When pH becomes alkaline, protection against infection decreases. In general, these bacteria or fungi infect the soft skin parts of the outer ear canal that have been irritated by water. Hence otitis externa disease is often referred to as the disease "ear swimmers or a swimmer's ear".

The ear canal can also be irritated by or due to external crumbs (e.g. sand), too often clean the ear, side effects of hearing aids, complications from other ear diseases (e.g. ear canal eczema).

Otitis Externa is divided into two, namely acute and chronic otitis. In the case of acute otitis externa is usually caused by bacterial infections, the most common cause bacteria are Pseudomonas aeruginosa and Staphylococcus aureus. Other pathogens that can cause otitis externa are gram-negative bacteria and fungal infections (otomycosis). Meanwhile, chronic otitis externa is caused by allergies or autoimmune disorders.

Based on the causes of inflammation in the ear canal, there are bacteria: (otitis externa circumcripta/furuncle, otitis externa diffuse, and malignant otitis externa) and fungi (otomycosis).

An otitis externa diffuse is a diffuse inflammation of the skin of the ear canal that extends to the ear leaf and the epidermis layer of the eardrum. The disease is most common in conditions with high humidity and heat as well as on swimmers. Excessive sweating changes the skin pH of the ear rut from acid to the base, causing the growth of pathogenic germs. Two factors are most responsive to this condition, namely ear canal trauma and an invasion of pathogenic germs. Trauma can occur due to radical ear scrapes, and when clearing the ears after a swim where the skin of the earwax occurs maceration. Continuous damage to the earwax skin causes the entry of germs. The disease is characterized by itchy complaints, it can also be accompanied by pain in acute infections.

Otitis externa circumscripta is an acute bacterial infection of the ear canal in the form of a furuncle in the ear canal. The symptoms are a great pain, not according to the size of furuncle. Pain can also arise when opening the mouth.

Malignant otitis externa is a potentially life-threatening outer ear infection. Occurs in elderly patients with diabetes and immunocompromised.

Otomycosis is a fungi infection in the ear canal,  usually along with chronic bacterial infections of the ear canal. The main symptom is itching in the ear canal.

The treatment of otitis external patients is based on the causes. For example, if the infection is caused by a fungus, then the doctor will give a ear drop medication that contains anti-fungus. Similarly, if otitis externa is caused by bacteria, the drug with antibiotic content will be given to the patient. To relieve inflammation, usually, the doctor will give the ear drops that contain steroids. In the case of otitis externa accompanied by pain, the doctor will also include painkillers according to the severity of the pain such as ibuprofen, acetaminophen (paracetamol), and naproxen.

For healing to run faster, it is advisable to protect your ears from water during the treatment of otitis externa, such as by clogging the ears when bathing and avoiding swimming or diving. Besides, avoid using hearing aids or other electronic devices that are mounted in the ear before the pain subsides and do not travel by plane until otitis external conditions are declared cured by a physician.