Diffuse inflammation of the external auditory canal: causes, symptoms, diagnosis, treatment

Diffuse external otitis is characterized by inflammation of the skin of the external auditory canal, encompassing the membranous-cartilaginous and bony parts of it. Inflammation covers all layers of the skin and subcutaneous tissue, it can spread to the tympanic membrane, causing its inflammation (meryngitis).

Causes of diffuse inflammation of the external auditory canal

Most often, diffuse external otitis occurs as a complication of chronic purulent otitis media as a result of skin contact with purulent discharge or as a result of infection with gram-negative pyogenic microorganisms affected skin eczema or with furunculosis of the external auditory canal. Diffuse otitis externa often occurs due to traumatizing the skin of the external auditory canal and drift of infection. The disease can also occur if there is IT in the external auditory canal or when aggressive substances enter it. The contributing factors are the same as in the case of eczema of the external auditory canal.

Symptoms of diffuse inflammation of the external auditory canal

At the beginning of the disease the patient feels a strong itch in the external auditory canal, a feeling of bursting and warmth. Then there is a growing pain, intensifying with masticatory movements. The pain radiates to the corresponding half of the head. Endoscopically determined diffuse hyperemia and swelling of the skin of the external auditory canal. On the skin appear erosion and serous effusion, which then turns into purulent discharge. In the future, the phenomenon of inflammation progresses, the infiltration of the skin and subcutaneous tissue increases and completely obturates the external auditory canal. The skin sharply thickens and becomes covered with cracks and ulcers, from which yellowish-greenish pus is secreted. Regional lymph nodes (pre-, retro- and subauricular) are enlarged, painful to the touch and, if untimely treated, can be abscessed.

The swelling period can last 2-3 weeks, after which the disease can spontaneously or, as a result of the treatment, get reverse development and be eliminated. However, in protracted cases the process acquires a chronic course, as a result of which there are scarring stenoses of the external auditory canal, up to its complete obliteration. In the latter case, pronounced conductive hearing loss occurs.

Along with the described banal form of diffuse external otitis, a similar disease can occur in some common infectious diseases, for example, hemorrhagic form of viral etiology, in diphtheria, smallpox, etc. In particularly severe forms of diffuse external otitis media, the process can spread to the auricle and periauricular areas.

Diagnosis of diffuse inflammation of the external auditory canal

The basis for direct diagnosis is the clinical picture described above. Differentiate the disease from acute eczema, furuncle, erysipelas, acute purulent otitis media. Each of these diseases has its own characteristics.

Treatment of diffuse inflammation of the external auditory canal

The main goal of the medical measures is prevention of frequently occurring stenosis and obliteration of the external auditory canal. In the initial stage, locally recommended Turundas with Boer liquid or 1-2% yellow mercury ointment, injected into the external auditory meatus 2-3 times a day. It is also possible to irrigate the external auditory canal with penicillin solution. When purulent secretions of the external auditory canal appear, they are washed with antiseptic solutions followed by the introduction of an alcohol solution of boric acid, or 2% silver nitrate solution, or an appropriate antibiotic on a turunde. Simultaneously, they carry out general antibiotic and vitamin therapy, as well as measures recommended for furuncle and infected eczema of the external auditory canal.

[1], [2], [3], [4], [5]