403:, in which there are no symptoms and the fungus simply co-exists in the ear canal in a commensal relationship with the host, in which case the only physical finding is the presence of a fungus. If the fungus begins active reproduction, the ear canal can fill with dense fungal debris, causing pressure and ever-increasing pain that is unrelenting until the fungus is removed from the canal and anti-fungal medication is used. Most antibacterial ear drops also contain a steroid to hasten resolution of canal edema and pain. Unfortunately, such drops make the fungal infection worse. Prolonged use of them promotes the growth of fungus in the ear canal. Antibacterial ear drops should be used for a maximum of one week, but 5 days is usually enough. Otomycosis responds more than 95% of the time to a three-day course of the same over-the-counter anti-fungal solutions used for athlete's foot.
656:
canal to be effective. The physician may need to carefully insert a wick of cotton or other commercially available, pre-fashioned, absorbent material called an ear wick and then saturate that with the medication. The wick is kept saturated with medication until the canal opens enough that the drops will penetrate the canal without it. Removal of the wick does not require a health professional. Antibiotic ear drops should be dosed in a quantity that allows coating of most of the ear canal and used for no more than 4 to 7 days. The ear should be left open. It is imperative that visualization of an intact
713:
Beginning as infection of the external ear canal, there is an extension of the infection into the bony ear canal and the soft tissues deep to the bony canal. Unrecognized and untreated, it may result in death. The hallmark of malignant otitis externa (MOE) is unrelenting pain that interferes with sleep and persists even after swelling of the external ear canal may have resolved with topical antibiotic treatment. It can also cause skull base osteomyelitis (SBO), manifested by multiple cranial nerve palsies, described below under the "Treatment" heading.
49:
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from injury caused by attempts at self-cleaning or scratching with cotton swabs, pen caps, fingernails, hair pins, keys, or other small implements. Another causative factor for acute infection is prolonged water exposure in the forms of swimming or exposure to extreme humidity, which can compromise the protective barrier function of the canal skin, allowing bacteria to flourish, hence the name "swimmer's ear".
322:
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susceptible to further damage if the ear is instrumented with cotton swabs after swimming. Main symptoms of swimmer’s ear are a feeling of fullness in the ear, itchiness, redness, and swelling in or around the ear canal, muffled hearing, pain in the external ear and ear canal and especially a smelly discharge from the ear.
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can spread deeper into the head and involve the bones of the skull base, constituting skull base osteomyelitis (SBO). Multiple cranial nerve palsies can result, including the facial nerve (causing facial palsy), the recurrent laryngeal nerve (causing vocal cord paralysis), and the cochlear nerve (causing deafness).
618:
Ear drops are the mainstay of treatment for external otitis. Some contain antibiotics, either antibacterial or antifungal, and others are simply designed to mildly acidify the ear canal environment to discourage bacterial growth. Some prescription drops also contain anti-inflammatory steroids, which
574:
when swimming and shampooing hair may help prevent external otitis, there are important details in the use of plugs. Hard and poorly fitting earplugs can scratch the ear canal skin and set off an episode. When earplugs are used during an acute episode, either disposable plugs are recommended, or used
414:
in polluted water is a common way to contract swimmer's ear, but it is also possible to contract swimmer's ear from water trapped in the ear canal after a shower, especially in a humid climate. Prolonged swimming can saturate the skin of the canal, compromising its barrier function and making it more
345:
Tenderness of pinna is the predominant complaint and the only symptom directly related to the severity of acute external otitis. Unlike other forms of ear infections, we observe tenderness in outer ear i.e., the pain of acute external otitis is worsened when the outer ear is touched or pulled gently.
536:
The skin of the bony ear canal is unique, in that it is not movable but is closely attached to the bone, and it is almost paper-thin. For these reasons, it is easily abraded or torn by even minimal physical force. Inflammation of the ear canal skin typically begins with a physical insult, most often
438:
or other small objects to clear the ear canal is enough to cause breaks in the skin, and allow the condition to develop. Once the skin of the ear canal is inflamed, external otitis can be drastically enhanced by either scratching the ear canal with an object or by allowing water to remain in the ear
801:
in 1969 there was a great deal of otitis externa. The Diving
Medical Officer devised a prophylaxis that came to be known as, "Tektite Solution", equal parts of 15% tannic acid, 15% acetic acid and 50% isopropyl alcohol or ethanol. During Tektite ethanol was used because it was available in the lab
312:
Otitis externa affects 1–3% of people a year; more than 95% of cases are acute. About 10% of people are affected at some point in their lives. It occurs most commonly among children between the ages of seven and twelve and among the elderly. It occurs with near equal frequency in males and females.
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Unlike ordinary otitis externa, MOE requires oral or intravenous antibiotics for cure. Pseudomonas is the most common offending pathogen. Diabetes control is also an essential part of treatment. When MOE goes unrecognized and untreated, the infection continues to smolder and over weeks or months
655:
Removal of debris (wax, shed skin, and pus) from the ear canal promotes direct contact of the prescribed medication with the infected skin and shortens recovery time. When canal swelling has progressed to the point where the ear canal is blocked, ear drops may not penetrate far enough into the ear
354:
that projects out just in front of the ear canal opening, also typically causes pain in this condition as to be diagnostic of external otitis on physical examination. People may also experience ear discharge and itchiness. When enough swelling and discharge in the ear canal is present to block the
712:
Necrotizing external otitis (malignant otitis externa) is an uncommon form of external otitis that occurs mainly in elderly diabetics, being somewhat more likely and more severe when the diabetes is poorly controlled. Even less commonly, it can develop due to a severely compromised immune system.
775:
are paralyzed, shortness of breath may develop and necessitate tracheotomy. Profound deafness can occur, usually later in the disease course due to relative resistance of the inner ear structures. Gallium scans are sometimes used to document the extent of the infection but are not essential to
725:
course than ordinary acute otitis externa. There may be granulation involving the floor of the external ear canal, most often at the bony-cartilaginous junction. Paradoxically, the physical findings of MOE, at least in its early stages, are often much less dramatic than those of ordinary acute
630:
Although the acute external otitis generally resolves in a few days with topical washes and antibiotics, complete return of hearing and cerumen gland function may take a few more days. Once healed completely, the ear canal is again self-cleaning. Until it recovers fully, it may be more prone to
491:
at the initial examination because of narrowing of the ear canal from inflammation and the presence of drainage and debris. Sometimes the diagnosis of external otitis is presumptive and return visits are required to fully examine the ear. The culture of the drainage may identify the bacteria or
742:
The infecting organism is almost always pseudomonas aeruginosa, but it can instead be fungal (aspergillus or mucor). MOE and SBO are not amenable to surgery, but exploratory surgery may facilitate the culture of unusual organism(s) that are not responding to empirically used anti-pseudomonal
646:
to reduce itching and inflammation. In painful cases, a topical solution of antibiotics such as aminoglycoside, polymyxin or fluoroquinolone is usually prescribed. Antifungal solutions are used in the case of fungal infections. External otitis is almost always predominantly bacterial or
583:
during otherwise "dry" exercise in the summer has been associated with the development of swimmer's ear since the plugs can create a warm and moist environment inside the ears. The source claims that on-ear or over-ear headphones can be a better alternative for preventing swimmer's ear.
556:
After prolonged swimming, a person prone to external otitis can dry the ears using a small battery-powered ear dryer, available at many retailers, especially shops catering to watersports enthusiasts. Alternatively, drops containing dilute acetic acid (vinegar diluted 3:1) or
619:
help to resolve swelling and itching. Although there is evidence that steroids are effective at reducing the length of treatment time required, fungal otitis externa (also called otomycosis) may be caused or aggravated by overly prolonged use of steroid-containing drops.
512:
In contrast to the chronic otitis externa, acute otitis externa (AOE) is predominantly a bacterial infection, occurs suddenly, rapidly worsens, and becomes painful. The ear canal has an abundant nerve supply, so the pain is often severe enough to interfere with sleep.
358:
Because the symptoms of external otitis lead many people to attempt to clean out the ear canal (or scratch it) with slim implements, self-cleaning attempts generally lead to additional traumas of the injured skin, so rapid worsening of the condition often occurs.
371:
that can infect the skin and (2) impairments in the integrity of the skin of the ear canal that allow an infection to occur. If the skin is healthy and uninjured, only exposure to a high concentration of pathogens, such as submersion in a pond contaminated by
788:
The incidence of otitis externa is high. In the
Netherlands, it has been estimated at 12–14 per 1000 population per year, and has been shown to affect more than 1% of a sample of the population in the United Kingdom over a 12-month period.
622:
Antibiotics by mouth should not be used to treat uncomplicated acute otitis externa. Antibiotics by mouth are not a sufficient response to bacteria which cause this condition and have significant side effects including increased risk of
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being the drug of choice). The usual surgical finding is diffuse cellulitis without localized abscess formation. SBO can extend into the petrous apex of the temporal bone or more inferiorly into the opposite side of the skull base.
1623:
Kashiwamura M. Chida E. Matsumura M. Nakamaru Y. Suda N. Terayama Y. Fukuda S. The efficacy of Burow's solution as an ear preparation for the treatment of chronic ear infections. Otology & Neurotology. 25(1):9–13,
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to the base of the skull are more likely to develop complications, including malignant otitis externa. In these individuals, rapid examination by an otolaryngologist (ear, nose, and throat physician) is very important.
499:
The diagnosis may be missed in most early cases because the examination of the ear, with the exception of pain with manipulation, is nearly normal. In some early cases, the most striking visual finding is the lack of
1984:
1969:
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into the ear canal: use of cotton buds or swabs is the most common event leading to acute otitis externa. Most normal ear canals have a self-cleaning and self-drying mechanism, the latter by simple evaporation.
483:-like, with scaly shedding of skin. Touching or moving the outer ear increases the pain, and this maneuver on physical exam is important in establishing the clinical diagnosis. It may be difficult to see the
1795:
Lesser FD, Derbyshire SG, Lewis-Jones H (28 August 2015). "Can computed tomography and magnetic resonance imaging differentiate between malignant pathology and osteomyelitis in the central skull base?".
627:. In contrast, topical products can treat this condition. Oral anti-pseudomonal antibiotics can be used in case of severe soft tissue swelling extending into the face and neck and may hasten recovery.
597:
Effective solutions for the ear canal include acidifying and drying agents, used either singly or in combination. When the ear canal skin is inflamed from the acute otitis externa, the use of dilute
1661:
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production, or if there has been a break in the skin from trauma, even the normal bacteria found in the ear canal may cause infection and full-blown symptoms of external otitis.
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may be used. It is especially important not to instrument ears when the skin is saturated with water, as it is very susceptible to injury, which can lead to external otitis.
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Rosenfeld RM, Schwartz, S. R., Cannon, C. R., Roland, P. S., Simon, G. R., Kumar, K. A., Huang, W. W., Haskell, H. W., Robertson, P. J. (3 February 2014).
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otitis externa. In later stages, there can be soft tissue swelling around the ear, even in the absence of significant canal swelling. While fever and
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fungus causing infection, but is not part of the routine diagnostic evaluation. In severe cases of external otitis, there may be swelling of the
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in the ear can combine with the swelling of the canal skin and the associated pus to block the canal and dampen hearing, creating a temporary
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might be expected in response to bacterial infection invading the skull region, MOE does not cause fever or elevation of white blood count.
1603:
504:. As a moderate or severe case of external otitis resolves, weeks may be required before the ear canal again shows a normal amount of it.
251:. The most common cause of otitis externa is bacterial. Risk factors for acute cases include swimming, minor trauma from cleaning, using
239:
Otitis externa may be acute (lasting less than six weeks) or chronic (lasting more than three months). Acute cases are typically due to
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around the ear. Typically, improvement occurs within a day of the start of treatment. Treatment of chronic cases depends on the cause.
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is a chronic disease that can require months of IV antibiotic treatment, tends to recur, and has a significant mortality rate.
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Otitis externa responds well to treatment, but complications may occur if it is not treated. Individuals with underlying
521:. In more severe or untreated cases, the infection can spread to the soft tissues of the face that surround the adjacent
376:, is likely to set off an episode. However, if there are chronic skin conditions that affect the ear canal skin, such as
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2297:
1677:
Rosenfeld RM, Brown L, Cannon CR, Dolor RJ, Ganiats TG, Hannley M, Kokemueller P, Marcy SM, Roland PS (2006-04-01).
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Rosenfeld RM, Brown L, Cannon CR, Dolor RJ, Ganiats TG, Hannley M, Kokemueller P, Marcy SM, Roland PS (2006-04-01).
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As the skull base is progressively involved, the adjacent exiting cranial nerves and their branches, especially the
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When the ear is inspected, the canal appears red and swollen in well-developed cases. The ear canal may also appear
1841:"Clinical efficacy of three common treatments in acute otitis externa in primary care: randomised controlled trial"
1744:
1901:
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1239:"Identification of infectious Pseudomonas aeruginosa strains in an occupational saturation diving environment"
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plugs must be cleaned and dried properly to avoid contaminating the healing ear canal with infected discharge.
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1312:
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is a very effective remedy against both bacterial and fungal external otitis. This is a buffered mixture of
1326:
Zichichi L, Asta G, Noto G (April 2000). "Pseudomonas aeruginosa folliculitis after shower/bath exposure".
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A severe case of acute otitis externa. Note the narrowing of the ear channel, the large amounts of
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A moderate case of otitis externa. There is narrowing of the ear channel, with a small amount of
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771:, may be affected, resulting in facial paralysis and hoarseness, respectively. If both of the
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455:
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1020:
Lee H, Kim J, Nguyen V (September 2013). "Ear infections: otitis externa and otitis media".
1913:
660:(eardrum) is noted. Use of certain medications with a ruptured tympanic membrane can cause
1557:"Wearing earbuds in the summer could cause a nasty ear infection — here's how to avoid it"
1210:
Cobet AB, Wright DN, Warren PI (June 1970). "Tektite-I program: bacteriological aspects".
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have suggested that most people will have at least a brief episode at some point in life.
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ear drops may be used as a preventive measure. Treatment of acute cases is typically with
48:
8:
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2185:
1988:
1082:
Kang K, Stevens SR. Pathophysiology of atopic dermatitis. Clin
Dermatol 2003; 21:116–121.
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The two factors that are required for external otitis to develop are (1) the presence of
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may be used for the pain. Antibiotics by mouth are not recommended unless the person has
248:
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117:
109:
74:
1917:
1638:
1189:"Surfer Ears – University of California Irvine Otolaryngology –?Head & Neck Surgery"
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The strategies for preventing acute external otitis are similar to those for treatment.
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529:, making chewing painful. In its mildest forms, otitis externa is so common that some
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predominantly fungal so that only one type of medication is necessary and indicated.
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Avoid washing hair or swimming if very mild symptoms of acute external otitis begin.
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1288:"A Prophylactic Program for the Prevention of Otitis Externa in Saturation Divers"
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459:, followed by a great number of other gram-positive and gram-negative species.
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1596:"Swimmers Ear – Additional Advice About A Pesky and Sometimes Painful Problem"
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1978:
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species are the most common fungal pathogens responsible for the condition.
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Schaefer P, Baugh RF (1 December 2012). "Acute otitis externa: an update".
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opening, external otitis may cause temporary conductive hearing loss.
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1745:"Malignant otitis externa: experience with hyperbaric oxygen therapy"
1505:"Clinical Practice Guideline: Acute Otitis Externa Executive Summary"
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298:
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256:
233:
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138:
113:
1902:""Tektite": A Blueprint for Cooperative Undersea Scientific Program"
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Saxby A, Barakate M, Kertesz T, James J, Bennett M (December 2010).
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Rapini, Ronald P., Bolognia, Jean L., Jorizzo, Joseph L. (2007).
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Those who live in warm and wet climates are more often affected.
244:
57:
236:. A high fever is typically not present except in severe cases.
1973:
1060:"What are the symptoms of ear infection - inner, middle, outer"
514:
501:
480:
399:, range from inconsequential to extremely severe. Fungi can be
373:
615:, and is available without prescription in the United States.
321:
1838:
1292:
United States Navy
Experimental Diving Unit Technical Report
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as an adjunct to antibiotic therapy remains controversial.
631:
repeat infection from further physical or chemical insult.
434:
Even without exposure to water, the use of objects such as
426:
have reported otitis externa during occupational exposure.
1742:
1676:
1368:
1294:. NEDU-RR-10-74. Archived from the original on 2008-08-20
2111:
1658:
American
Academy of Otolaryngology–Head and Neck Surgery
1640:
American
Academy of Otolaryngology–Head and Neck Surgery
275:
the ear canal may be useful in chronic or severe cases.
989:
1644:"Five Things Physicians and Patients Should Question"
993:
Harwood-Nuss' Clinical
Practice of Emergency Medicine
1951:
996:. Lippincott Williams & Wilkins. p. PT428.
1839:van Balen F, Smit W, Zuithoff N, Verheij T (2003).
1679:"Clinical practice guideline: acute otitis externa"
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1548:
1371:"Clinical practice guideline: acute otitis externa"
1236:
1473:
1471:
1209:
1092:Wang MC, Liu CY, Shiao AS, Wang T (August 2005).
990:Wolfson AB, Hendey GW, Ling LJ, Rosen CL (2009).
2274:
1545:
1325:
1091:
680:, disorders of the immune system, or history of
418:Constriction of the ear canal from bone growth (
271:. Diagnosis is based on the signs and symptoms.
255:and ear plugs, and other skin problems, such as
1738:
1736:
1734:
1732:
232:. Typically there is pain with movement of the
1468:
1140:
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692:Spread of infection to other areas of the body
293:drops may be used in addition to antibiotics.
228:, swelling of the ear canal, and occasionally
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1763:. Archived from the original on June 16, 2013
1425:
960:
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1579:: CS1 maint: multiple names: authors list (
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1237:Ahlén C, Mandal LH, Iversen OJ (July 1998).
1134:
1019:
905:Wipperman J (March 2014). "Otitis externa".
668:, dizziness and hearing loss in some cases.
129:Swimming, minor trauma from cleaning, using
1600:Diver's Alert Network: Alert Diver Magazine
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1555:Avella Delano Samuels, Jessica Orwig, Joe.
579:According to one source, the use of in-ear
395:Fungal ear canal infections, also known as
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439:canal for any prolonged length of time.
422:) can trap debris leading to infection.
328:
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823:
2293:Bacterium-related cutaneous conditions
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1664:from the original on September 1, 2013
1428:"Microbiology of acute otitis externa"
1010:
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933:
316:
243:, and chronic cases are often due to
1683:Otolaryngology–Head and Neck Surgery
1509:Otolaryngology–Head and Neck Surgery
1483:The Lecturio Medical Concept Library
1375:Otolaryngology–Head and Neck Surgery
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721:MOE follows a much more chronic and
733:
13:
1554:
716:
14:
2319:
1947:
1048:
564:Avoid swimming in polluted water.
507:
447:The majority of cases are due to
429:
1906:Journal of the Atomic Scientists
1900:Ray E, Cohen R (February 1970).
1594:Doc Vikingo (March–April 2007).
1445:10.1097/00005537-200207000-00005
1340:10.1046/j.1365-4362.2000.00931.x
805:
758:
267:are at risk of a severe form of
1932:from the original on 2017-02-15
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1147:JAMA Otolaryngol Head Neck Surg
1141:Pierre JJ, Tolisano AM (2023).
783:
776:disease management. Skull base
1926:10.1080/00963402.1970.11457770
1749:Diving and Hyperbaric Medicine
1085:
1076:
983:
634:Effective medications include
592:
531:ear nose and throat physicians
496:(s) directly beneath the ear.
325:A mild case of otitis externa.
42:External otitis, swimmer's ear
1:
1111:10.1016/S1726-4901(09)70174-1
816:
540:
442:
350:, the tablike portion of the
89:, swelling of the ear canal,
16:Inflammation of the ear canal
1696:10.1016/j.otohns.2006.02.014
1426:Roland P, Stroman D (2002).
1388:10.1016/j.otohns.2006.02.014
671:
587:
474:
7:
2169:Eustachian tube dysfunction
1058:Meghanadh DK (2022-01-26).
698:Otitis externa haemorhagica
695:Necrotizing external otitis
650:
406:
10:
2324:
1094:"Ear problems in swimmers"
809:
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773:recurrent laryngeal nerves
20:
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1955:
1857:10.1136/bmj.327.7425.1201
1810:10.1017/S0022215115001991
1780:: CS1 maint: unfit URL (
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1159:10.1001/jamaoto.2023.0997
1034:10.1016/j.pop.2013.05.005
964:American Family Physician
919:10.1016/j.pop.2013.10.001
835:Dermatology: 2-Volume Set
812:Otitis externa in animals
753:hyperbaric oxygen therapy
362:
224:. It often presents with
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2298:Diseases of external ear
2174:Patulous Eustachian tube
1522:10.1177/0194599813517659
1143:"What Is Swimmer's Ear?"
802:for pickling specimens.
642:to fight infection, and
269:malignant otitis externa
21:Not to be confused with
1651:: an initiative of the
625:opportunistic infection
519:conductive hearing loss
689:Chronic otitis externa
450:Pseudomonas aeruginosa
342:
337:, and swelling of the
326:
163:Differential diagnosis
2198:Middle ear barotrauma
1438:(7 Pt 1): 1166–1177.
1286:Thalmann, ED (1974).
456:Staphylococcus aureus
382:seborrheic dermatitis
332:
324:
307:infection of the skin
2191:Gradenigo's syndrome
1255:10.1136/oem.55.7.480
837:. St. Louis: Mosby.
570:Although the use of
388:or abnormalities of
303:poor immune function
249:autoimmune disorders
203:~2% of people a year
118:autoimmune disorders
93:, difficulty chewing
60:and swelling of the
1918:1970BuAtS..26b..35R
241:bacterial infection
154:Based on symptoms,
110:Bacterial infection
75:Otorhinolaryngology
2208:Perforated eardrum
2042:External resources
1886:2006-03-10 at the
1689:(4 Suppl): S4-23.
1381:(4 Suppl): S4–23.
343:
327:
317:Signs and symptoms
2270:
2269:
2079:
2078:
1642:(February 2013),
1243:Occup Environ Med
1199:on July 17, 2009.
1003:978-0-7817-8943-1
844:978-1-4160-2999-1
682:radiation therapy
658:tympanic membrane
609:aluminium sulfate
424:Saturation divers
378:atopic dermatitis
230:decreased hearing
207:
206:
156:microbial culture
150:Diagnostic method
91:decreased hearing
28:Medical condition
2315:
2303:Swimming culture
2213:Tympanosclerosis
2186:Bezold's abscess
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1851:(7425): 1201–5.
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1561:Business Insider
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1479:"Otitis Externa"
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849:
848:
830:
734:Treatment of MOE
707:
706:
605:Burow's solution
601:may be painful.
559:Burow's solution
549:Avoid inserting
462:Candida albicans
295:Pain medications
289:or acetic acid.
51:
31:
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2323:
2322:
2318:
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2308:Sports injuries
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2113:Diseases of the
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1888:Wayback Machine
1837:
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1789:
1773:
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1653:ABIM Foundation
1649:Choosing Wisely
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799:Tektite Project
795:
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708:external otitis
704:
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1956:Classification
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1948:External links
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1804:(9): 852–859.
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1755:(4): 195–200.
1728:
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263:. People with
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210:Otitis externa
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191:drops such as
186:
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806:Other animals
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774:
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759:Complications
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743:antibiotics (
740:
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2260:tympanometry
2234:Hearing loss
2203:Otitis media
2135:
2060:
2049:
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2014:
1983:
1968:
1934:. Retrieved
1912:(2): 35–40.
1909:
1905:
1895:
1879:
1848:
1844:
1834:
1801:
1797:
1790:
1776:cite journal
1765:. Retrieved
1752:
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1682:
1666:, retrieved
1647:
1619:
1608:. Retrieved
1599:
1589:
1564:. Retrieved
1560:
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1498:
1486:. Retrieved
1482:
1435:
1432:Laryngoscope
1431:
1421:
1378:
1374:
1364:
1331:
1327:
1321:
1307:cite journal
1296:. Retrieved
1291:
1281:
1246:
1242:
1232:
1215:
1211:
1205:
1197:the original
1192:
1183:
1150:
1146:
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1101:
1097:
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1078:
1067:. Retrieved
1063:
1025:
1022:Primary Care
1021:
992:
985:
968:
962:
910:
907:Primary Care
906:
834:
796:
787:
784:Epidemiology
765:facial nerve
762:
750:
741:
737:
728:leukocytosis
720:
711:
675:
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617:
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448:
446:
436:cotton swabs
433:
420:Surfer's ear
417:
410:
394:
366:
357:
346:Pushing the
344:
311:
305:or there is
277:
268:
253:hearing aids
238:
218:inflammation
213:
209:
208:
131:hearing aids
125:Risk factors
23:Surfer's ear
18:
2181:Mastoiditis
2051:MedlinePlus
797:During the
769:vagus nerve
751:The use of
705:Necrotizing
640:antibiotics
638:containing
613:acetic acid
599:acetic acid
593:Medications
468:Aspergillus
401:saprophytic
279:Acetic acid
178:Acetic acid
39:Other names
2288:Pediatrics
2277:Categories
2151:Middle ear
2141:Otomycosis
2120:middle ear
2027:DiseasesDB
1936:2012-11-03
1767:2013-05-18
1610:2008-07-22
1566:2023-11-07
1298:2008-07-22
1212:Aerosp Med
1153:(7): 652.
1069:2022-05-30
913:(1): 1–9.
817:References
810:See also:
581:headphones
541:Prevention
494:lymph node
443:Infections
397:otomycosis
283:antibiotic
261:dermatitis
189:Antibiotic
174:Prevention
143:dermatitis
2255:pneumatic
2128:Outer ear
2070:emerg/350
2062:eMedicine
1881:Full text
1705:0194-5998
1668:August 1,
1488:25 August
1397:0194-5998
1175:259000499
1064:Medy Blog
672:Prognosis
636:ear drops
588:Treatment
527:jaw joint
475:Diagnosis
386:psoriasis
339:outer ear
299:ibuprofen
287:ofloxacin
273:Culturing
257:psoriasis
245:allergies
234:outer ear
222:ear canal
200:Frequency
193:ofloxacin
185:Treatment
180:ear drops
139:psoriasis
114:allergies
70:Specialty
62:outer ear
2250:Otoscope
2229:Ear pain
2222:Symptoms
2067:ped/1688
1930:Archived
1884:Archived
1875:14630756
1818:26314320
1761:23111934
1721:20340836
1713:16638473
1662:archived
1604:Archived
1575:cite web
1539:26425210
1531:24492208
1462:24612139
1454:12169893
1413:20340836
1405:16638473
1356:39610780
1348:10809975
1167:37261805
1128:20037932
1120:16138712
1042:23958363
977:23198673
927:24439876
767:and the
723:indolent
678:diabetes
662:tinnitus
651:Cleaning
572:earplugs
551:anything
525:and the
489:otoscope
487:with an
412:Swimming
407:Swimming
297:such as
265:diabetes
226:ear pain
135:diabetes
87:Ear pain
82:Symptoms
2156:mastoid
2021:D010032
1914:Bibcode
1826:7874505
1273:9816382
1264:1757612
1224:4392833
793:History
666:vertigo
485:eardrum
390:keratin
352:auricle
335:exudate
291:Steroid
220:of the
58:exudate
2283:Otitis
2056:000622
2002:112.82
1998:054.73
1994:053.71
1873:
1866:274056
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502:earwax
481:eczema
374:sewage
363:Causes
348:tragus
106:Causes
2243:Tests
2116:outer
2010:380.2
2006:380.1
1822:S2CID
1717:S2CID
1535:S2CID
1458:S2CID
1409:S2CID
1352:S2CID
1171:S2CID
1124:S2CID
369:germs
216:, is
98:Types
2154:and
2118:and
2032:9401
2016:MeSH
1989:9-CM
1910:XXIV
1871:PMID
1814:PMID
1782:link
1757:PMID
1709:PMID
1701:ISSN
1670:2013
1624:2004
1581:link
1527:PMID
1490:2021
1450:PMID
1401:PMID
1393:ISSN
1344:PMID
1313:link
1269:PMID
1220:PMID
1163:PMID
1116:PMID
1038:PMID
998:ISBN
973:PMID
923:PMID
839:ISBN
611:and
465:and
453:and
259:and
247:and
1985:ICD
1979:H60
1970:ICD
1922:doi
1861:PMC
1853:doi
1849:327
1845:BMJ
1806:doi
1802:129
1691:doi
1687:134
1517:doi
1513:150
1440:doi
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1259:PMC
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915:doi
515:Wax
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