Swimmer’s Ear AKA Acute Otitis Externa

Swimmer’s Ear AKA Acute Otitis Externa 

An outer ear infection, aka; Swimmer’s Ear, AKA Otitis Externa,is an infection of the outer opening of the ear and the ear canal, known collectively as the External Acoustic Meatus. This does not involve the area on the inner aspect of the eardrum.  Infections here are known as Middle ear infections or Otitis Media.

Causes:

Outer ear infections often result from exposure to moisture and frequent submersion of ears under water. It’s more common in people who spend a lot of time in the water. Swimmer’s ear results in nearly 2.4 million visits to doctors’ offices and urgent cares annually in the United States.

The anatomy and physiology of the external auditory canal predisposes certain individuals to infections. In fact, children, who have a more narrow, external auditory canal or an increase risk for developing infections. Ultimately, swimmers ear is a disease process in which moisture becomes trapped in the external auditory canal, which then create an environment, favorable for the growth and proliferation of certain bacteria.Our body does have a natural defense against this in the form of cerumen, or wax. However, in some individuals, there is not a significant enough amount of wax to create the barrier to prevent the moisture from sitting into the soft tissue. Ultimately, swimmers and bathers, and people who spend a significant amount of time in moist environments are at increased risk for development of swimmers ear. In addition, scratches, and abrasions to the lining of the external auditory canal can become inflamed and infected as well.

Prevention:

There are multiple things that can be done to prevent swimmers ear from occurring. These include, wearing soft earplugs while swimming. Using a swim cap can also create some thing as a watertight seal and preventing fluid and water from getting into the ear canal. It is always advisable to avoid scratching the inner ear. Keep in mind, Q-tips are designed to clean the outer aspect of the ear. The Q-tip itself should never penetrate the orifice of the external auditory canal.In addition, people who remove earwax to frequently deprive themselves of that protective layer. Also, it is possible to use a 50% rubbing alcohol, 25% distilled water 25% white vinegar mixture to create an environment in the ear that is quite unfavorable for the growth of bacteria.Lastly, keeping in mind that the change in environment also comes into play. Meaning, if you spend a significant amount of your time in a very dry cold environment and you are on a vacation closer to the tropics where the air is significantly more humid and warmer, this is a set up for creation of otitis externa. Therefore, this is the time when the above mentioned solution would come most in handy.

Symptoms:

The symptoms of acute otitis externa include swelling, pain at the external site, there can be redness, or a warm sensation over the ear. At times, pus can be seen leaking from the canal itself. Patient sometimes describe a muffled or diminished hearing acuity as well.If a patient with acute otitis externa develops severe pain over the face or the eyes, or behind the ear, these are all concerning symptoms and need to be addressed immediately. If a fever occurs, this as well is a potential significant symptom, and needs to be addressed immediately.

Treatment:

Treatment for outer ear infections include use of antibiotic eardrops. Antibiotic, eardrops, specifically ciprofloxacin-based are the mainstay of treatment. These antibiotics are usually administered twice a day. It works best if the antibiotic drop can sit in the external auditory canal for 15 to 20 minutes after being administered.Occasionally, the antibiotic drops might be mixed with a steroid, which will help reduce some of the inflammation in the ear canal as well. Of note, ciprofloxacin, otic solution should not be placed in the eye. For pain control, over-the-counter medication's like Tylenol, and Advil can be used safely. 

Conclusion: 

Swimmers. The ear can be extremely annoying in a time of excruciating illness to deal with. It is avoidable when the appropriate precautions are undertaken. If, however, despite taking reasonable precautions, the swimmer's ear infection occurs. The proper medications must be administered as quickly as possible. Letting this kind of infection go untreated for any significant time can cause considerable complications and worsen and delay symptoms. As referenced above, people must recognize any increased risk factors. They may have for the development of swimmers' ears, and if they take the appropriate precautions to avoid this uncomfortable infection from sitting in the first place.

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