45 year old lady comes with right ear pain with itching and discharge. She has just returned from holiday in Cyprus.
Pathophysiology Superficial infection of EAC Obstruction- cerumen, narrow EAC, exostosis EAC, hearing aid Trauma P H alteration Role of PH of external auditory canal in acute otitis externa. Kumar S, Indian j head and neck surgery 2014, Jan 66(1):86-91
Principles of treatment Topical treatment in uncomplicated OE- Suction Analgesics Keeping ear dry Ear swabs - only in resistant/ chronic OE
Ear swab Only if condition does not improve with empirical topical treatment OE is recurrent After ear surgery Infection beyond EAC BMJ 2014 Llor, McNulty et al
A study of acute otitis externa at Wellington hospital 2007-2011, Jayakar, Sanders, Jones Australasian Med J 2014
Choice of ear drops History of previous ear problem-?perforation State of ear canal If the swab results available Cost Sofradex ear drops- £6.25 + VAT Gentisone HC ear drops- £4.76+VAT Cipro- £4.70+VAT Otomise ear spray- £3.50+ VAT Locartan vioform ear drops- £1.76+ VAT
Delivery of ear drops Narrow EAC Use of Pope wick