BABY AND CHILDHOOD DISORDERS OF THE EARS, NOSE AND THROAT: EXTERNAL EAR INFECTION (OTITIS EXTERNA)
The ear canal may easily become infected. There are many causes. Excessive swimming and showering, with water lying in the canal for prolonged periods of time, enable germs to become firmly entrenched. The lining of the canals becomes soft, soggy and often macerated. A yellowish discharge may occur and may continue in an area around the outer entrance to the canal. This may scab over with yellowish crusts, and additional infective organisms may become established here as well.
Injury from fiddling with things in the outer ear (bobby pins and pencils are notorious), foreign bodies, eczema from other areas (frequently from seborrhoeic dermatitis extending down from the scalp) are all common. It may be very uncomfortable. Debris may accumulate there and hearing loss may temporarily occur. Glands in the front of the ear may swell and become painful. Often swimming in a heavily chlorinated pool may produce a chemical reaction in the canal, and this may be painful and allow secondary infection. It is common in children, often in summer at the start of the swimming season.
Treatment
Treatment is aimed at clearing the debris and gunk from the canal and keeping it infection-free and dry, and free from injury. The simple do-it-yourself remedies are cleansing the outside of the canal and the outer part of the canal, but only as far in as you can see. A cotton wool bud dipped in liquid paraffin is often helpful. Obvious infections on the outer part may be cleansed with a weaky (pink only) condy's crystal solution.
Most ear infections should be checked by the doctor, for there is often a lot of debris in the canal needing clearing, and a proper routine usually gives the best results. The doctor can see deeply inside the canal with an auriscope, an instrument with a light that allows easy examination of the entire canal and drums. The doctor has the facilities for cleaning canals that are filled with debris.
Often antibiotics are needed if there is infection present. This may be broad spectrum—there are several effective ones in popular use, and penicillin and its synthetic derivatives are often highly successful.
As many different organisms may be present, including bacteria, funguses (such as the tinea germ) or yeasts (such as monilia), a combination ear cream, such as kenacomb otic, may be prescribed. Sometimes, in severe infections the canal is filled with this cream for a few days. Or a thin smear may be applied to the canal two to three times a day. Ideally the canal must be kept dry (avoid swimming, for example) until the infection is entirely cleared up.
If an antibiotic is prescribed by the doctor, make sure your child takes the entire course. Otherwise a chronic infection could occur with the germs that were not completely killed during the original infection. This could lead to a lot of problems in future.
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