Otitis externa risk factors: Difference between revisions

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{{Otitis externa}}
{{Otitis externa}}
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==Overview==
==Overview==
Common risk factors in the development of otitis externa include swimming, use of objects such as [[cotton swab]]s to clear the ear canal, and impaction of [[cerumen]] in the ear canal.
Risk factors for acute otitis externa include activities and conditions that predispose an individual to [[ear canal]] [[inflammation]]. They 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.
**Swimming in public pools or other unclean bodies of water, heightening the chance of [[bacterial]] or [[fungal]] infection.
 
**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>
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.
**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>
 
**Loss of [[cerumen]] in the [[ear canal]], lowering the amount of [[ear canal]] protective coating.
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.
**Experiencing foreign objects that can cause [[irritation]] and [[inflammation]], such as hearing aids or ear plugs.
**Having [[ear canal]] obstructions, such as [[sebaceous cysts]].
**Experiencing [[suppuration]] from other ear diseases such as [[otitis media]]
**Undergoing prolonged treatment with topical [[antibiotics]].<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>
***Raises risk of [[otomycosis]].
**Experiencing physical trauma in the [[ear canal]].
**Repeating 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]], including the following:<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==

Revision as of 19:14, 11 May 2016

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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.

Overview

Risk factors for acute otitis externa include activities and conditions that predispose an individual to ear canal inflammation. They 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. ↑ "Estimated Burden of Acute Otitis Externa --- United States, 2003--2007".
  3. ↑ 3.0 3.1 Schaefer P, Baugh RF (2012). "Acute otitis externa: an update". Am Fam Physician. 86 (11): 1055–61. PMID 23198673.
  4. ↑ 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.
  5. ↑ "Malignant otitis externa: MedlinePlus Medical Encyclopedia".

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