What is ear canal inflammation?
Ear canal inflammation is an inflammation of the skin in the area of the external auditory canal. The medical term for this is “otitis externa” – from “otitis” = inflammation of the ear and “externa” = outside.
The external auditory canal runs in an S-shape from the pinna to the eardrum and is about two to 3.5 centimeters long. The auditory canal is very narrow at the transition between the cartilaginous (outer) and the bony part. Dirt particles and foreign bodies can therefore easily get stuck there.
There are glands in the ear canal that secrete earwax. Earwax has an important protective and cleansing function for the ear canal: on the one hand, it has antimicrobial properties. This means that it kills bacteria and inhibits the growth of fungi. Secondly, it transports germs or dirt to the outside via the ear canal.
If small injuries occur – for example due to improper cleaning of the ears – bacteria or fungi can enter the ear canal and cause inflammation. The same applies if contaminated water from swimming pools or bathing lakes gets into the ear canal. For this reason, experts often refer to inflammation of the ear canal as “swimmer’s ear” or swimmer’s otitis.
Ear canal inflammation – frequency and age
Inflammation of the ear canal is widespread: Around one in ten people will develop otitis externa in the course of their lives. When bathing or swimming, pathogens can easily enter the ear canal with the water. This is why people who spend a lot of time in the water (swimmers, divers, surfers) and children are particularly frequently affected by swimmer’s ear or swimmer’s otitis. Diabetics and hearing aid wearers also often suffer from ear canal inflammation.
Ear canal inflammation: causes and risk factors
There are various possible causes of inflammation of the ear canal (otitis externa). Frequent triggers are:
Skin injuries: For example, incorrect cleaning of the ears with cotton buds can cause tiny skin injuries in the ear canal. As a result, bacteria can enter and the ear canal can become inflamed.
Frequent cleaning: Earwax has an important cleaning and protective function. Frequent cleaning of the ear canal with cotton buds or soap removes the protective earwax. This makes it easier for bacteria and fungi to colonize the ear canal.
Contact with water: Inflammation of the ear canal is also common after swimming or bathing in swimming pools or lakes. The reason for this is bacterially contaminated water that enters the ear canal and does not drain away immediately.
Other possible causes of ear canal inflammation are
- Too much earwax
- Benign bone protrusions in the auditory canal (exostoses)
- Chronic otitis media
- Ear canal eczema
- Boils (infection of a hair follicle by bacteria)
- Allergies to soap, shampoos or hairspray
- “moist chamber” in the ear due to hearing aids, earplugs or absorbent cotton
- Tumor in the ear canal
Symptoms: Ear canal inflammation
Inflammation of the ear canal (otitis externa) is usually initially characterized by severe itching. This is followed by severe ear pain, which is aggravated by chewing movements or pulling on the auricle.
Fluid often comes out of the affected ear, sometimes also pus. It is also possible that the auditory canal swells up. As a result, those affected can also hear less well. Other possible symptoms are fever and swollen lymph nodes in the neck area.
Ear canal inflammation can also become chronic. In this case, those affected mainly suffer from itching.
Ear canal inflammation: Diagnosis with us
If an inflammation of the ear canal (otitis externa) is suspected, we will carry out a physical examination. Typically, the earache intensifies when we pull the pinna backwards and upwards or on the earlobe or press on the cartilage protrusion in front of the entrance to the ear canal.
We can also confirm the diagnosis with an otoscopy. In the case of ear canal inflammation, the ear canal is reddened and swollen. Sometimes fluid accumulations (secretions) and impurities are also visible. If the swelling makes it difficult to hear, we will arrange for a hearing test if necessary.
To find out the exact causes, an X-ray, a smear test, a blood test or an allergy test may also be necessary in individual cases. Computed tomography (CT) or magnetic resonance imaging (MRI) can also be used.
Ear canal inflammation: prevention, early detection, prognosis
There are several measures you can take to prevent otitis externa:
- Earwax has an important self-cleaning and protective function. You should therefore refrain from constantly cleaning your ears.
- If you use cotton buds: Be very careful when doing so. Otherwise, tiny skin lesions can occur through which bacteria can enter the tissue.
- Avoid cleaning your ears with soap. As soap is alkaline, it can change the natural pH value of the ear canal.
- A moist ear canal provides excellent growth conditions for bacteria and fungi. You should therefore keep your ears dry or dry them well after bathing and showering or carefully blow dry them.
- If you wear a hearing aid or are prone to increased earwax build-up, you should have your ears cleaned regularly by an ear, nose and throat specialist.
- If you are diabetic, it is important to check your blood sugar levels regularly and have them properly adjusted.
Course and prognosis of ear canal inflammation
In most cases, inflammation of the ear canal (otitis externa) heals on its own after a few days or weeks. However, the process can also be very painful and protracted. If ear canal inflammation occurs frequently over a long period of time, it can also become chronic.
If an inflammation of the ear canal spreads and spreads to the surrounding tissue, an abscess (accumulation of pus) can occur as a complication. In addition, the auricle or the adjacent parotid gland can become inflamed. Other possible complications are cartilage or bone damage. This can be the case with diabetes mellitus (diabetes) or immunodeficiency. In rare cases, the inflammation spreads to the cranial nerves and causes paralysis.
Ear canal inflammation: Treatment depending on severity
In the case of otitis externa, we will first clean the ear canal. Depending on the cause, the inflammation is treated with locally applied medication, such as antibiotics in the form of ointments or ear drops. In the case of diabetics or complications, we administer antibiotics as tablets or infusions. Ointments containing cortisone (glucocorticoids) help to reduce swelling. If fungal pathogens are the cause, we will prescribe an antifungal agent (antimycotic).
If there is severe pain, painkillers are also indicated. If pus has accumulated in the ear, we can remove it with a minor surgical procedure. For the therapy to be successful, your help as the person affected is also required. For example, it is important to ensure that your ear canal is dry after showering or bathing. Cooling and disinfecting compresses are also helpful. As chewing movements often increase the pain, it is advisable to switch to soft foods such as porridge and soups during the inflammation.
