Ear canal inflammation

Mareike Müller is a freelance writer in the medical department and assistant doctor for neurosurgery in Düsseldorf. She studied human medicine in Magdeburg and gained a lot of practical medical experience during her stays abroad on four different continents.

More about the experts All content is checked by medical journalists.

When the ear canal is inflamed (otitis externa), the outer ear canal is inflamed. The reason for this is usually a bacterial infection. This is often caused by an injury or other illness such as diabetes or the flu. An inflammation of the ear canal is very painful. It can often be treated well with medication. But it can also be life-threatening. Here you can read everything you need to know about ear canal inflammation.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. H60

Ear canal inflammation: description

Medical professionals describe inflammation of the external auditory canal in the ear as ear canal inflammation (otitis externa). Depending on what causes an inflammation of the ear canal and what symptoms it causes, one can differentiate between different types:

External otitis circumscripta

In this simplest form of ear canal inflammation, a hair follicle in the ear canal is inflamed (boils). It is usually triggered by bacteria that colonize the skin, the staphylococci. This form of ear canal inflammation is limited to a small area.

Diffuse external otitis

This type of ear canal inflammation is the most common. The entire ear canal is affected. The inflammation is mostly caused by bacteria, and sometimes by fungi.

External otitis necroticans

This form of ear canal inflammation is also known as otitis externa maligna, i.e. a malignant ear canal inflammation. It develops from otitis externa diffusa if the chosen therapy does not help. This leads to the death of inflamed tissue (necrosis). The inflammation can also spread and affect the bones of the skull or some cranial nerves.

External otitis bullosa hemorrhagica

This type of ear canal inflammation occurs as part of the flu (influenza) and is therefore also known as flu otitis. Most of the time, the ear canal and eardrum are affected by the inflammation at the same time. Bloody bubbles form on these structures as a result of damage to the smallest blood vessels (capillaries). The middle ear is also often affected.

Ear canal inflammation: symptoms

Patients with inflammation of the ear canal often complain of the following symptoms:

itching
Redness
Discharge from the ear, possibly with crust formation
Hearing loss due to the swelling of the ear canal
overheat
severe earache
severe pain when speaking or chewing
Pain when pressure on the cartilage in front of the entrance to the ear canal (tragus)
Pain when pulling on the earlobe

In addition, there may be fever and fatigue as well as other symptoms of colds such as cough.

Ear canal inflammation: causes and risk factors

Inflammation of the ear canal can be caused by bacteria, viruses and fungi. It often occurs when the sensitive skin of the ear canal is injured by cleaning with cotton swabs or when there is too little protective ear wax due to frequent cleaning.

The development of an ear canal inflammation is favored overall by the following factors:

Moisture in the ear after showering, bathing, or swimming
frequent swimming in chlorinated water
Injuries from cotton swabs or ear plugs
Diseases that favor the occurrence of infections such as diabetes mellitus
Use of drugs that weaken the immune system
Allergies to soaps, hairsprays, cosmetics or hearing aid earmolds

Ear canal inflammation: examinations and diagnosis

To make the diagnosis of ear canal inflammation, your doctor will first ask you in detail about your medical history (anamnesis). He will ask you the following questions, for example:

When did the complaints start?
Do you have a fever or feel exhausted?
Do you feel that you can hear worse in the affected ear?
Have you ever had similar complaints before?
Do you have diabetes?

Then the doctor will examine your ears. First, he looks for any external abnormalities such as redness, discharge or swelling. Then he tests it for tenderness. Finally, he performs an otoscopy to see any changes in the ear canal.

If you report a hearing loss, a hearing test may be carried out afterwards.

Your doctor can also take a smear test to find out which pathogen is responsible for the inflammation of the ear canal.

Ear canal inflammation: treatment

Treatment for ear canal inflammation depends on the type and severity of the disease:

External otitis circumscripta

This form of ear canal inflammation is treated locally with antibiotics and anti-inflammatory ointments such as ointments containing cortisone.

If a pus-filled capsule (abscess) forms or the eardrum is affected by the inflammation of the ear canal, the abscess is cut open. In addition, the patient now receives antibiotics in tablet form (systemic antibiotic therapy). Painkillers such as paracetamol or acetylsalicylic acid are also often given.

Diffuse external otitis

During the treatment, the ear canal is first carefully cleaned. Then alcohol-containing ear drops are used to kill the pathogens. To do this, a strip of gauze is soaked in the solution and placed in the ear canal. This must be changed several times a day.

Only in the case of very severe inflammation or if the patient has diabetes are antibiotics or antifungal drugs (anti-fungal agents) prescribed in tablet form. In addition, the blood sugar level of diabetics should be well controlled.

External otitis necroticans

In milder cases, antibiotics are sufficient in addition to therapy with gauze strips, as is the case with otitis externa diffusa. The active ingredients are first given directly into a vein via infusions. The patient then receives the antibiotics in tablet form.

In severe cases of otitis externa necroticans, the destroyed tissue is removed in an operation. The same applies if the antibiotic therapy has not yet been successful after three weeks.

Otitis externa bullosa haemorrhagica

There is no effective drug against the influenza viruses themselves. However, because there is a risk of an additional bacterial infection (superinfection), patients are given antibiotics as a precaution. In addition, patients must be monitored because the infection can spread and lead to inflammation of the brain stem (brain stem encephalitis).

Ear canal inflammation: home remedies

In addition to the medication your doctor prescribes, there are various home remedies that can help heal an ear canal infection. These include onion, chamomile tea and warmth.

Onions have a disinfecting effect and help kill pathogens. If you have an inflammation of the ear canal, you can make an onion sachet for your ear: cut an onion into small pieces and wrap it in a kitchen towel. Then place this on your ear.

Chamomile has anti-inflammatory properties. You can make chamomile tea and put the used tea bag to your ear.

In the case of ear canal inflammation, heat primarily helps relieve the pain. If you have a heat lamp, adjust it and point it at your ear when you feel comfortable. But a warm grain pillow or a hot water bottle can also be beneficial.

Inflammation of the ear canal: disease course and prognosis

The prognosis for the simplest form of ear canal inflammation, otitis externa circumscripta, is good. The inflammation usually heals without consequences - with adequate therapy, the symptoms usually improve within a few days. However, if an abscess is not removed in time, the inflammation can spread to the auricle (perichondritis).

The otitis externa diffusa usually heals without consequences. However, especially in diabetics, there is a risk that it will recur. It can also develop into otitis externa necroticans, a dangerous form of ear canal inflammation. Inflammation lasts for several weeks. Under certain circumstances, otitis externa necroticans can even be life-threatening for the patient.

Otitis externa bullosa haemorrhagica is a rare form of ear canal inflammation. Usually it heals without any consequences.