15.1.1 Otitis External
It is an inflammatory condition of the pinna and external auditory meatus.
Diagnostic Criteria
- Itchy, dry and scaly ear canal and painful ear
- There may be a water or purulent discharge, debris and reduced hearing
- Pain may become extreme when the ear canal becomes completely occluded with edematous skin and debris.
Non-Pharmacological Treatment:
- Exclude an underlying chronic suppurative otitis media before commencing treatment.
- Do a thorough aural toilet at least once a week (ear suctioning under direct vision).
- Instruct the patient to thoroughly clean the ear with a dry cotton wick regularly and keep it dry.
Pharmacological Treatment:
C: Ciprofloxacin ear drops 3 drops 8 hourly for 7 days
15.1.2 Cerumen Impaction
Usually occurs following the use of cotton buds which hinder the natural movement of cerumen outwards
Non-Pharmacological Treatment:
- Remove using cerumen hook, syringing or suctioning under direct vision
15.1.3 Foreign Body in the Ear
Usually happens in children. Common foreign bodies include beads, stones and seeds (bean, maize, orange). In adults foreign bodies include cotton bud and insect
Non-Pharmacological Treatment:
- Restrain the child
- Remove using a cerumen hook under direct vision (if the child cannot be restrained, sedation is advised)
- An insect should be killed (by soaking the ear canal with normal saline or spirit) before removal