• Michael W Mather, Hassan Mohammed, and Janet A Wilson.
• Department of Otolaryngology, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK.
• Fam Pract. 2022 Sep 24; 39 (5): 971-973.

IntroductionReferrals for otitis externa (OE) have dramatically increased but the reasons for this remain unclear. We aim to characterize management of patients both pre- and post-referral to identify areas of improvement at the primary-secondary care interface.MethodsQuestionnaire study from consultant-led research clinic specifically set up to prospectively analyse OE referrals at a tertiary referral centre for Otolaryngology.ResultsSixty-two patients were included; 63% female, median age 57 years. One was excluded (clinically not OE). Most patients had multiple primary care visits before referral (average 4 GP; 2 practice nurse). Sixty per cent had received oral antibiotics (16% multiple classes). Eighteen per cent had never had ear drops. Thirty-nine per cent were not advised to keep ears dry. Twenty-one per cent had dermatitis; 13% contact allergy, 30% systemic allergy, 5% diabetes. Less than 10% had narrow canals. Thirty-six per cent had active discharge but <7% needed a wick. Approximately 75% appear suitable for community aural care clinics.ConclusionsOE occurs most commonly in female patients, often with associated risk factors. Patients often consult primary care several times prior to referral. Lifestyle advice and ototopical drops are frequently overlooked; instead, often inappropriately treated with oral antibiotics. Most ears were anatomically normal, and community aural care clinics may have a role in more timely and accessible treatment.© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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