ENT: Otitis externa: Free MSRA Podcast

🎧 FREE MSRA PODCAST – Otitis Externa (Swimmer’s Ear) ExplainedEssential, rapid revision of Otitis Externa for the MSRA: causes, clinical clues, red flags, and management—all straight from UK NICE-guided notes and exam themes. Boost your ENT knowledge, whether you’re prepping for exams or patient care!🧠 Key Learning PointsDefinition• Otitis externa is inflammation or infection of the external ear canal (often called “swimmer’s ear”).• Usually bacterial (Pseudomonas, Staph aureus), less commonly fungal (Candida, Aspergillus).• Can be acute (<3 weeks), chronic (>3 months), or necrotising (rare, severe).Natural Defences• Ear canal self-cleans by epithelial migration.• Earwax (cerumen) contains lysozyme & other antimicrobial agents.• Defence breakdown (moisture, trauma, eczema) = ↑ infection risk.Causes• Infectious: bacteria (Pseudomonas, Staph aureus), fungi (Candida, Aspergillus).• Non-infectious: moisture (swimming), cotton buds, irritants (hairspray, eardrops), dermatological issues (eczema, psoriasis).Risk Factors• Swimming, especially in children (7–12 years).• Diabetes, immunosuppression.• Hearing aids, earphones, narrow canals, wax imbalance, prior otitis externa, grommets, ear trauma, radiotherapy.• Skin disease (eczema, psoriasis).Pathophysiology• Breakdown in skin barrier → infection/inflammation in canal.• Results in: pain, swelling, redness, discharge, hearing loss.Differential Diagnosis• Otitis media, cholesteatoma, chronic suppurative otitis media, foreign body, impacted wax, malignancy, referred pain (teeth, jaw, sinuses), barotrauma, eczema.Epidemiology (UK)• ~10% lifetime risk.• Peak: ages 7–12.• More frequent in females.• 1–3% of GP visits; only ~3% need ENT referral.• Peaks in late summer (swimming!).Clinical Features• Otalgia, itching, discharge, fullness, hearing loss, pain on tragus or pinna movement.• Exam: red, swollen canal, scaly skin, ± cellulitis, lymphadenopathy.Types• Acute diffuse OE – most common, bacterial, widespread swelling.• Chronic OE – often fungal/inflammatory.• Furuncle – boil, localised, very painful.• Contact dermatitis – allergic/irritant.• Necrotising OE – invasive, life-threatening, especially in diabetics/immunosuppressed (severe pain, facial nerve palsy = red flag, urgent ENT referral).Investigations• Clinical diagnosis usually sufficient.• Ear swabs only if recurrent, severe, or non-resolving.• Signs of perforation: taste of drops, air escapes from ear on Valsalva, known grommets.• Imaging (CT/MRI) if necrotising OE suspected.Management• Topical: Antibiotic + steroid drops (ciprofloxacin + dexamethasone), acetic acid for mild/preventive.• Aural toilet: Debris removal (avoid syringing if perforated, use microsuction).• Oral antibiotics: Only for severe cellulitis/systemic illness—use flucloxacillin or erythromycin.• ENT advice: If severe or not responding.• Ear wicks may be needed for drops in swollen canal.• Self-care: Keep ear dry, avoid trauma, use swimmer’s drops before/after swimming, olive oil for wax, manage eczema.• Prevention: No cotton buds, careful with earphones.Complications• Cellulitis, abscess, temporary hearing loss.• Chronic OE, necrotising OE (skull base osteomyelitis), sepsis (rare).• Red flags: severe pain, facial palsy, diabetes/immunosuppressed, refer urgently.📎 More Otitis Externa Revision Resources:📝 Revision Notes: https://www.passthemsra.com/topic/otitis-externa-revision-notes/💬 Flashcards: https://www.passthemsra.com/topic/otitis-externa-flashcards/🧠 Q&A Notes: https://www.passthemsra.com/topic/otitis-externa-accordion-qa-notes/📝 Rapid Quiz: https://www.passthemsra.com/topic/otitis-externa-rapid-quiz/📚 ENT Course: https://www.passthemsra.com/courses/ent-for-the-msra/#MSRA #OtitisExterna #SwimmersEar #ENT #MSRARevision #MedicalEducation #UKGuidelines #EarInfection #PassTheMSRA #FreeMSRA #MalignantOtitisExterna #MedicalPodcast #Revision