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, covering its membranous-cartilaginous and bony parts. The inflammation covers all layers of the skin and subcutaneous tissue, and can spread to the eardrum, causing its inflammation (meryngitis).

Causes of diffuse inflammation of the external auditory canal

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

Symptoms of diffuse inflammation of the external auditory canal

At the onset of the disease, the patient feels intense itching, a feeling of distension and warmth in the external auditory canal. Then, increasing pain appears, which intensifies with chewing movements. The pain radiates to the corresponding half of the head. Diffuse hyperemia and edema of the skin of the external auditory canal are determined endoscopically. Erosions and serous effusion appear on the skin, which then turns into purulent discharge. Subsequently, the inflammation progresses, the infiltrate of the skin and subcutaneous tissue increases and completely obstructs the external auditory canal. The skin thickens sharply and becomes covered with cracks and ulcers, from which yellowish-greenish pus is released. Regional lymph nodes (pre-, retro- and subauricular) are enlarged, painful to the touch and, if not treated in a timely manner, may abscess.

The peak period can last 2-3 weeks, after which the disease can spontaneously or as a result of treatment reverse and be eliminated. However, in protracted cases the process becomes chronic, resulting in cicatricial stenosis of the external auditory canal, up to its complete obliteration. In the latter case, severe conductive hearing loss occurs.

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

Diagnosis of diffuse inflammation of the external auditory canal

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

Treatment of diffuse inflammation of the external auditory canal

The main goal of the treatment is to prevent frequently occurring stenosis and obliteration of the external auditory canal. At the initial stage, locally recommended are turundas with Burow's solution or 1-2% yellow mercury ointment, introduced into the external auditory canal 2-3 times a day. Irrigation of the external auditory canal with a penicillin solution is also possible. If purulent discharge appears, the external auditory canal is washed with antiseptic solutions followed by the introduction of an alcohol solution of boric acid, or a 2% solution of silver nitrate, or an appropriate antibiotic on a turunda. At the same time, general antibiotic and vitamin therapy is carried out, as well as measures recommended for furuncle and infected eczema of the external auditory canal.

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