Outer Ear Conditions

What is Out Ear?

The outer ear comprises the pinna (ear lobe) and the ear canal.

Outer Ear Structure

Common Outer Ear Condition

The most common outer ear condition in adults and children is a condition called otitis externa. Otitis externa is an inflammation of the skin of the ear canal.

The ear canal has got two parts; the outer half is made of cartilage, the inner part is made of bone. The skin of the ear canal, particularly in the inner half, is densely adherent to bone and any swelling tends to cause severe pain.

The most common cause of outer ear infection is a bacterial infection of the skin of the ear canal. There are always lots of bacteria in the ear canal as well as funguses and viruses, and these tends not to become pathological unless a condition occurs where they can multiple and get under the skin.

The most common sequence of events is outer ear infection after swimming. If the ear canal is contaminated by water containing a large number of bacteria, the canal and some residual fluid retained in the ear canal, the canal provides a wonderful environment for bacteria to grow and multiple. It is 37.5 degrees and the shed protein or keratin from the skin in the ear canal is a great source for the bacteria to multiple. If supra-added to this, there is a small cut or laceration in the ear canal, this large bacteria load can get under the skin causing outer ear infections.

Bacterial outer ear infections are either localised or diffuse. Localised are almost like a pimple on your face, and are confined to a small area of the ear canal, while diffuse outer ear infections affect the whole ear canal. Severe diffuse bacterial otitis externa can be occlusive. This means that the skin gets swollen to the extent that the ear canal is blocked.

The major symptoms of an outer ear infection are pain, discharge and diminished hearing acuity.

Outer Ear Conditions Treatment

Appropriate first-line treatment for an outer ear infection is:

  • It is very important for your local doctor or ENT surgeon to clean the ear canal as this removes not only a large bacterial load, but a lot of the proteinaceous material and fluid in which the bacteria multiple.
  • If the infection looks at all atypical, a swab can be taken for culturen sensitivity.
  • First line treatment involves appropriate topical antibiotic eardrops.
  • The exclusion of water from the ear canal.
  • Not scratching or cleaning or irritating the skin in the ear canal.

Under these circumstances, reasonable expectation is marked improvements in symptoms in 48 hours and resolution in 3 to 5 days.

Fungal outer ear infections, like bacterial outer ear infections, can be diffuse or localised.

They are acquired in 2 ways:

  • A large noculen of fungus, which is usually water-born or from the fingers.
  • After a long course of broad-spectrum antibiotic eardrops, the normal symbiosis between bacteria and fungi is upset: all the bacteria are killed, the fungi thrive and cause a diffuse fungal otitis externa.

The principles of treating fungal outer ear disease are the same as they are for bacterial outer ear disease, namely:

  • Cleaning the ear canal.
  • Excluding water.
  • Not scratching or cleaning the way in any way.
  • The use of topical fungicidal eardrops.

If you are suffering from any outer ear conditions, please contact Havas ENT Clinics on 02 9387 7360 for help.

If you doubt you have ear conditions on middle ear or inner ear, please find the information here: