Otitis externa risk factors: Difference between revisions

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==Overview==
Risk factors for acute otitis externa include activities and conditions that predispose an individual to [[ear canal]] [[inflammation]]. Risk factors also include being a female between 65 and 74 years old. Risk factors for malignant necrotizing otitis externa include conditions predisposing an individual to [[immunocompromise]] including undergoing [[chemotherapy]] or suffering from [[diabetes mellitus]].


==Risk Factors==
==Risk Factors==
[[Swimming]] in polluted water is a common way to contract swimmer's ear, but it is also possible to contract swimmer's ear from water trapped in the ear canal after a shower, especially in a humid climate.<ref>{{cite journal |author=Wang MC, Liu CY, Shiao AS, Wang T |title=Ear problems in swimmers |journal=J Chin Med Assoc |volume=68 |issue=8|pages=347–52 |year=2005 |month=August |pmid=16138712 |doi= |url= |accessdate= }}</ref> Saturation divers have reported otitis externa during occupational exposure.<ref>{{cite journal |author=Cobet AB, Wright DN, Warren PI |title=Tektite-I program: bacteriological aspects |journal=Aerosp Med |volume=41 |issue=6 |pages=611–6 |year=1970 |month=June|pmid=4392833 |doi= |url= |accessdate= }}</ref><ref>{{cite journal |author=Ahlén C, Mandal LH, Iversen OJ |title=Identification of infectious Pseudomonas aeruginosa strains in an occupational saturation diving environment |journal=Occup Environ Med |volume=55 |issue=7
*Risk factors for acute otitis externa include activities and conditions that predispose an individual to [[ear canal]] [[inflammation]]:<ref name="urlSwimmers ear : MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000622.htm |title=Swimmer's ear : MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
|pages=480–4 |year=1998 |month=July |pmid=9816382 |pmc=1757612 |doi= |url= |accessdate= }}</ref><ref>{{cite journal |author=Thalmann, ED |title=A Prophylactic Program for the Prevention of Otitis Externa in Saturation Divers. |journal=US Naval Experimental Diving Unit Technical Report |volume=NEDU-RR-10-74 |date=1974|url=http://archive.rubicon-foundation.org/3372 |accessdate=2008-07-22 }}</ref> Even without exposure to water, the use of objects such as [[cotton swab]]s or other small objects to clear the ear canal is enough to cause breaks in the skin, and allow the condition to develop.<ref>{{cite journal |author=Zichichi L, Asta G, Noto G|title=Pseudomonas aeruginosa folliculitis after shower/bath exposure |journal=Int. J. Dermatol. |volume=39 |issue=4 |pages=270–3 |year=2000 |month=April |pmid=10809975 |doi=|url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0011-9059&date=2000&volume=39&issue=4&spage=270 |accessdate=2008-07-22}}</ref> Once the skin of the ear canal is inflamed, external otitis can be drastically enhanced by either scratching the ear canal with an object, or by allowing water to remain in the ear canal for any prolonged length of time.
**Scuba-diving increases the risk of trapped water in the [[ear canal]].<ref name="pmid23022815">{{cite journal |vauthors=Azizi MH |title=Ear disorders in scuba divers |journal=Int J Occup Environ Med |volume=2 |issue=1 |pages=20–6 |year=2011 |pmid=23022815 |doi= |url=}}</ref>
 
**Swimming in public pools or other unclean bodies of water increases the chance of [[bacterial]] or [[fungal]] infection.
Impaction of [[cerumen]] that abuts up against the delicate skin of the bony canal, or attempts to remove the impacted wax, can also be the initial event. Other inciting factors can be foreign bodies or cysts that develop in the skin near or just inside the canal opening.
**Living in a humid or tropical climate<ref name="urlEstimated Burden of Acute Otitis Externa --- United States, 2003--2007">{{cite web |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a2.htm |title=Estimated Burden of Acute Otitis Externa --- United States, 2003--2007 |format= |work= |accessdate=}}</ref>
 
**Developing [[dermatoses]] such as [[eczema]], [[seborrhea]], and [[psoriasis]]<ref name="pmid23198673">{{cite journal |vauthors=Schaefer P, Baugh RF |title=Acute otitis externa: an update |journal=Am Fam Physician |volume=86 |issue=11 |pages=1055–61 |year=2012 |pmid=23198673 |doi= |url=}}</ref>
The S-shape of the ear canal, the presence of hair in the outer part, and the outward migration of skin all combine to help shed water from the ear canal and keep shed skin from building up within the canal, as well as to keep water from pooling in the innermost canal. In some minor malformations of the ear canal or auricle, the size and shape of the canal may predispose allowing water that enters the ear to remain, or to inhibit the normal shedding of superficial skin and [[Earwax|cerumen]] from the ear canal. In such cases, the individual may have a predisposition to recurrent external otitis.
**Loss of [[cerumen]] in the [[ear canal]] thins the [[ear canal]] protective coating
**Introduction of foreign objects in the [[ear canal]] such as hearing aids, or ear plugs can cause [[irritation]] and [[inflammation]]
**[[Ear canal]] obstruction such as sebaceous cysts
**[[Suppuration]] from other ear diseases such as [[otitis media]]
**Undergoing prolonged treatment with topical [[antibiotics]] raises the risk of [[otomycosis]].<ref name="pmid23198673">{{cite journal |vauthors=Schaefer P, Baugh RF |title=Acute otitis externa: an update |journal=Am Fam Physician |volume=86 |issue=11 |pages=1055–61 |year=2012 |pmid=23198673 |doi= |url=}}</ref>
**Trauma to the [[ear canal]]
**Repeated exposure to irritants such as soaps, shampoos, or related cosmetic chemicals
**Having a narrow [[ear canal]] more prone to retaining water
*Being a female between age 65 and 74<ref name="pmid11462312">{{cite journal |vauthors=Rowlands S, Devalia H, Smith C, Hubbard R, Dean A |title=Otitis externa in UK general practice: a survey using the UK General Practice Research Database |journal=Br J Gen Pract |volume=51 |issue=468 |pages=533–8 |year=2001 |pmid=11462312 |pmc=1314044 |doi= |url=}}</ref>
*For malignant necrotizing otitis externa, contributors to [[immunocompromise]] include:<ref name="urlMalignant otitis externa: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000672.htm |title=Malignant otitis externa: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
**[[Chemotherapy]]
**[[Diabetes mellitus]]


==References==
==References==
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Latest revision as of 23:30, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.; Tarek Nafee, M.D. [2]

Overview

Risk factors for acute otitis externa include activities and conditions that predispose an individual to ear canal inflammation. Risk factors also include being a female between 65 and 74 years old. Risk factors for malignant necrotizing otitis externa include conditions predisposing an individual to immunocompromise including undergoing chemotherapy or suffering from diabetes mellitus.

Risk Factors

References

  1. ↑ "Swimmer's ear : MedlinePlus Medical Encyclopedia".
  2. ↑ Azizi MH (2011). "Ear disorders in scuba divers". Int J Occup Environ Med. 2 (1): 20–6. PMID 23022815.
  3. ↑ "Estimated Burden of Acute Otitis Externa --- United States, 2003--2007".
  4. ↑ 4.0 4.1 Schaefer P, Baugh RF (2012). "Acute otitis externa: an update". Am Fam Physician. 86 (11): 1055–61. PMID 23198673.
  5. ↑ Rowlands S, Devalia H, Smith C, Hubbard R, Dean A (2001). "Otitis externa in UK general practice: a survey using the UK General Practice Research Database". Br J Gen Pract. 51 (468): 533–8. PMC 1314044. PMID 11462312.
  6. ↑ "Malignant otitis externa: MedlinePlus Medical Encyclopedia".

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