Otitis externa; chronic

Alternative names:

chronic otitis externa; ear infection, external - chronic; external ear infection - chronic; swimmer's ear - chronic

Definition:

A persistent or recurrent inflammation or infection of the external ear and ear canal.

Causes, incidence, and risk factors:

Swimmer's ear (otitis externa) is fairly common. It usually responds to treatment, but about 1% of cases may become chronic. Chronic otitis externa affects about 4 out of 100,000 people, mostly teenagers and young adults. It consists of inflammation, irritation, or infection of the outer ear and ear canal. There may be a history of exposure to water or of mechanical trauma to the ear from scratching or foreign objects in the ear. Swimming in polluted water is one way to contract swimmer's ear. Attempts to clean wax from the ear canal, especially with cotton swabs or small objects, can irritate or damage the skin. Hair spray, hair dyes, shampoos, and other chemicals may also irritate the skin of the ear canal. Otitis externa may occasionally be associated with middle ear infection (otitis media) or with upper respiratory infections such as colds.

The presence of moisture predisposes the ear to infection from fungus or water-loving bacteria such as Pseudomonas or Proteus. These infections may be resistant to treatment or may recur, leading to chronic otitis externa.