Otitis externa: what are the symptoms? 

The major symptoms of otitis externa are: a feeling of fullness in the ear, itching and intense pain in the outer ear. (2) Otitis externa is an inflammation of the skin of the external ear canal. The swelling of this tissue is painful. This pathology, which is bacterial in origin in most cases, can be aggravated by certain factors. Moisture and trauma to the external ear canal, for example, can cause infection of the skin in the ear canal. (7)

A feeling of fulness in the air, itching and sharp pain in the external auditory canal... These are the symptoms of otitis externa! What is this ear disorder like? Why does it hurt?  

What are the symptoms of otitis externa?

Otitis externa is a common disease of the ear it is one of the most frequent causes of ENT consultations.1 This pathology manifests itself through various symptoms:

  • Feeling of fullness in the ear,
  • Itching in the external ear canal (pruritus),
  • Intense and throbbing pain (otalgia),
  • Clear flow that becomes purulent (otorrhea),
  • Swelling and redness of the external ear canal (erythema),
  • External ear canal obstruction.(2)

Otitis externa1: definition 

Characteristics of otitis externa

An otitis is the inflammation of a duct or cavity in the ear organ. The causes, characteristics and location of this inflammation define this generic term: acute otitis media, serous otitis... There are different types of otitis !

Otitis externa (OE) concerns the outer ear: more precisely, it is an acute inflammation of the skin of the external auditory canal (EAC). This canal starts after the tragus and extends from the bottom of the conch to the eardrum.3 In about 90% of cases, otitis externa is not localised but diffuse: the entire skin of the external ear canal is then affected by the inflammation. (4)

Infectious in origin, otitis externa is bacterial in about 90% of cases, and often mycotic the rest of the time.(5)

Why is otitis externa painful? 

From outside to inside, the external ear canal consists initially of a fibro-cartilaginous portion. It has a thick skin and houses the glands that produce wax . The second portion is bony and consists of smooth, dry skin adhering to the membrane that surrounds the bone, called the periosteum.(3)

When otitis externa occurs, the skin of the EAC will swell: this is one of the characteristics of inflammation.6 As this swelling takes place inside a cylindrical shape, the tissues will touch and crush each other, causing severe pain and obstruction of the canal. Otalgia can also be explained by the structure of the external auditory canal, mentioned above: as it swells, the skin of the EAC will stretch the periosteum, which is a very sensitive membrane.

Itching, pain and swelling: why does my ear hurt?

How can i prevent otitis externa and its symptoms? 

Preventing otitis externa consists above all in addressing its origin: what are the causes of otitis externa ?

Environmental humidity, use of certain irritating products (soap, shampoo...), earwax blockage, wearing an ill-adapted hearing aid... Frequent swimming is also a notable cause of otitis externa, which gives rise to an alternative name for this pathology: swimmer's ear . (5)

These factors can cause trauma to the external auditory canal, promote the proliferation of germs and thus cause bacterial inflammation. To protect against otitis externa, it is also recommended to clean your ears without a cotton bud . (7)

Let’s look further into this! How can I relieve ear pain?

Sources

(1) Otites externes : une maladie auto-infligée ? F. Bizindavyi J.-P. Guyot M.-I. Kos Rev Med Suisse 2007; volume 3. 32569. https://www.revmed.ch/RMS/2007...
(2) Symptômes, diagnostic et évolution d’une otite externe. 2019. https://www.ameli.fr/
(3) Service ORL du CHU d’Angers http://www.orl-chu-angers.fr/m... (consulté le 28/09/20)
(4) Batthikhi MN, Ammar SI. Otitis externa infections in Jordan, Saudi Med J 2004;25:1199-203. https://openmicrobiologyjourna...
(5) Otite externe : définitions et causes. 2019. https://www.ameli.fr/
(6) Futura Santé : inflammation, définition. https://www.futura-sciences.co... (consulté le 28/09/20)
(7) Société canadienne de pédiatrie, comité des maladies infectieuses et d’immunisation. L’otite externe aiguë. Paediatr Child Health. 2013;18(2):99-101. https://www.ncbi.nlm.nih.gov/p...