bubble_chart Overview

External otitis can be divided into two types: one is localized external otitis, also known as furuncle of external auditory canal; the other is diffuse inflammation of the external auditory canal skin, also known as diffuse otitis externa.

bubble_chart Auxiliary Examination

Examination of an external auditory canal furuncle reveals auricle traction pain and tragus tenderness, with localized redness and swelling of the skin in the cartilaginous portion of the external auditory canal. Severe furuncles on the posterior wall of the external auditory canal may cause redness and swelling in the postauricular sulcus and mastoid region. Diffuse external otitis also shows auricle traction pain and tragus tenderness upon examination, along with diffuse redness and swelling of the external auditory canal skin, abdominal mass secretions on the canal walls, narrowing of the external auditory canal lumen, and swollen, painful lymph nodes around the ear. The skin of the external auditory canal thickens, develops rhagades, and desquamates, with accumulated secretions potentially leading to stenosis of the external auditory canal.

bubble_chart Diagnosis

In cases of external auditory canal furuncle, ear pain is severe, worsens with mouth opening or chewing, and may radiate to the same side of the head. General malaise is common, and body temperature may slightly rise. When severe swelling obstructs the external auditory canal, tinnitus and hearing loss may occur. Examination reveals auricle traction pain and tragus tenderness, with localized redness and swelling of the skin in the cartilaginous portion of the external auditory canal. After the swelling matures and ruptures, pus accumulated in the external auditory canal drains out, leading to relief of ear pain. Severe furuncles on the posterior wall of the external auditory canal may cause redness and swelling in the postauricular sulcus and mastoid region, necessitating differentiation from acute mastoiditis. Patients with acute mastoiditis often have a history of acute or chronic suppurative otitis media, exhibit more pronounced fever, lack auricle traction pain but display mastoid tenderness, and may present with tympanic membrane perforation or significant tympanic membrane congestion along with abundant pus.

Acute diffuse external otitis manifests as ear pain and possible discharge. Examination also shows auricle traction pain and tragus tenderness, with diffuse redness and swelling of the external auditory canal skin. Secretions may accumulate on the canal walls, narrowing the lumen, and periauricular lymph nodes may become swollen and tender. In chronic cases, the ear feels itchy with slight exudate. The skin of the external auditory canal thickens, develops rhagades, and desquamates, with accumulated secretions potentially leading to canal stenosis.

bubble_chart Treatment Measures

1. Early local hot compress or physical therapy such as ultrashort wave diathermy.
2. Severe cases should be treated with antibiotics to control infection. Sedatives and analgesics may be administered.
3. Apply 1-3% phenol glycerin or 10% ichthammol glycerin drops to the affected ear, or use gauze strips soaked in the above solutions to dress the area, changing the gauze twice daily. For chronic cases, a combination of antibiotics and corticosteroids (such as prednisolone, dexamethasone, etc.) in ointment, paste, or cream form can be applied topically. Pus and secretions in the external auditory canal can be cleaned with 3% hydrogen peroxide.
4. Once the furuncle matures, promptly lance the pustule or perform incision and drainage.
5. Actively treat infectious foci such as suppurative otitis media, and diagnose and manage systemic conditions such as diabetes.