• Susanne Wiegand, Reinhard Berner, Antonius Schneider, Ellen Lundershausen, and Andreas Dietz.
• Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig; Department of Pediatrics, University Hospital Carl Gustav Carus Dresden, TU Dresden; Institute of General Practice, Technical University of Munich; HNO-Praxis Lundershausen, Erfurt.
• Dtsch Arztebl Int. 2019 Mar 29; 116 (13): 224-234.

BackgroundOtitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms.MethodsThis review is based on publications retrieved by a selective search of the pertinent literature.ResultsThe treatment of acute otitis media consists of anal- gesia, cleansing of the external auditory canal, and the appli- cation of antiseptic and antimicrobial agents. Local antibiotic and corticosteroid preparations have been found useful, but there have been no large-scale randomized controlled trials of their use. Topical antimicrobial treatments lead to a higher cure rate than placebo, and corticosteroid preparations lessen swelling, erythema, and secretions. Oral antibiotics are indi- cated if the infection has spread beyond the ear canal or in patients with poorly controlled diabetes mellitus or immuno- suppression. Chronic otitis externa is often due to an under- lying skin disease. Malignant otitis externa, a destructive infection of the external auditory canal in which there is also osteomyelitis of the petrous bone, arises mainly in elderly diabetic or immunosuppressed patients and can be life- threatening.ConclusionWith correct assessment of the different types of otitis externa, rapidly effective targeted treatment can be initi- ated, so that complications will be avoided and fewer cases will progress to chronic disease.

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