Otitis externa and media
Concept and Etiology: How does the disease affect the ear,
nose, throat, and gastrointestinal systems in particular? How
does it deviate from the definition of health discussed in
Module One?
Otitis refers to inflammation of the ear. Otitis Externa
refers to inflammation on the external ear canal, and
Otitis Media refers to inflammation of the ear drum. The
inflammation is generally caused by an infection but may
be cause by other things such as allergies and irritation.
Otitis Externa can be caused by things just as swimmer’s
ear, the drainage from otitis media, excessive ear wax,
cleaning ear wax, or foreign substances such as shampoo
or hairspray. (Lowth, 2016) Otitis Media can be cause by
things such as a cold, sore throat, or respiratory
infection (The John Hopskins University, 2021). While this
condition it can affect adults it is primarily seen in
children.
Classification: How is the disease classified?
According to Medscape Otitis Externa (OE) is classified by
the following (Waitzman, 2020):
Acute diffuse OE - Most common form of OE,
typically seen in swimmers
Acute localized OE (furunculosis)- Caused by an
infection of a hair follicle
Chronic OE - Same as acute diffuse OE but with a
longer duration (>6 weeks)
Eczematous (eczematoid) OE – Caused by skin
conditions such as atopic dermatitis, psoriasis,
systemic lupus erythematosus, and eczema that may
infect the external auditory canal and cause OE
Necrotizing (malignant) OE – An infection that
reaches into the deeper tissues adjacent to the
external auditory canal; occurs primarily in
immunocompromised adults such as diabetes or
AIDS
Otomycosis – An infection of the ear canal due to a
fungal species such as Candida, Aspergillus
oAccording to John Hopkins Otitis Media is classified by
the following (The John Hopskins University, 2021):
Acute otitis media- Is middle ear infection occurs
rapidly causing swelling and redness. Fluid and
mucus are trapped inside the ear, causing the
patient to have a fever and ear pain.
Otitis media with effusion. Fluid (effusion) and
mucus gather in the middle ear after an initial
infection subsides. The patient may have a feeling of
fullness in the ear and it may affect their hearing or
may have no symptoms.
Chronic otitis media with effusion. Fluid remains in
the middle ear for a extended period or continues to
return again and again, even though there is no
infection.
Clinical Manifestations (Symptoms and Signs): What are the
symptoms and signs of the disease or disorder? Be sure you
understand the difference between symptoms (subjective) and
signs (objective).
According to John Hopkins signs and symptoms may
include (The John Hopskins University, 2021):
o
Pain in one or both ears
Drainage
Muffled or reduced hearing
Sore throat
Irritability in children
Difficulty sleeping
Fever
Pus draining from ears
Loss of balance
Children may pull or tug on ears
Diagnostic Tests: What are some additional diagnostic tests
that can be done to illuminate the diagnosis? For example,
when you injure your ankle, they take an x-ray to determine if it
is broken or sprained.
Providers will have to conduct a physical examination to
diagnosis otitis media and externa. They will use an
otoscope to inspect the ear canal and ear drum. In some
case they may use a Tympanometry to check and make
sure the ear drum is working. Sometime if a patient has
multiple ear infections, providers may also do a hearing
test to see if infections have cause hearing loss.
References
Lowth, M. (2016, October 19). Ear Infection. Retrieved from Patient:
https://patient.info/ears-nose-throat-mouth/earache-ear-pain/ear-
infection-otitis-externa
The John Hopskins University. (2021). Ear Infection (Otitis Media).
Retrieved from John Hopkins Medicine:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/o
titis-media
Waitzman, M. F. (2020, March 9). What are the classifications of otitis
externa (OE)? Retrieved from Medscape:
https://www.medscape.com/answers/994550-8089/what-are-the-
classifications-of-otitis-externa-oe
