What do we define as summer otitis or otitis externa?

“We call this phenomenon, of increased moisture in the ear, otitis externa or swimmer’s ear. So we have an inflammation of the skin of the external auditory canal, that is, the tube that starts from the eardrum and reaches the eardrum. About 1% of people get it every year, mostly in the summer, while 10% of people overall will develop the infection at least once in their lifetime.

That is why it is very important to be well informed so that we know how to treat this particular infection and avoid the suffering of otitis”, points out Mr. Christos Gionis Director Otorhinolaryngologist at Metropolitan Hospital. It explains how otitis can be caused, its symptoms, its treatment, but above all it lists instructions to help protect the ears from summer otitis.

What causes otitis externa?

“It is mainly caused by bacteria, most commonly pseudomonas and staphylococcus, and more rarely by fungi (otomycosis), microbes that are anyway housed in the skin of the pore and under normal conditions do not cause problems. But, due to various factors, they find the opportunity to develop and show an infectious effect, causing otitis”.

What factors contribute to otitis externa?

“The factors vary, including environmental ones such as humidity, frequent exposure to water due to swimming and water sports, anatomical in patients with a narrow external auditory canal, skin conditions such as eczema and psoriasis and organic conditions such as diabetes mellitus, foreign body injuries with the use of swabs and hearing aids, but also irritants such as some soap, radiation therapy, chemotherapy, surgery and stress.

What are the most common symptoms of otitis externa?

“In children, the most common symptoms include ear pain, especially when lying down, fever of 38 ËšC or higher, severe headache, difficulty hearing, loss of balance, discharge of fluid from the external auditory canal (otorrhea), trouble sleeping, as well as irritability.

In adults, symptoms range from mild to more severe: they include pain, itching, heaviness, fever, irritation and tenderness of the area, blockage of the duct, hearing loss, and swelling of the cervical lymph nodes. If it is not treated in time and correctly, it can cause perichondritis of the ear, a condition that requires several times hospitalization and intravenous treatment.

Treatment must begin with the careful and thorough cleaning of the external auditory canal and the administration of local and systemic antibiotic and steroid treatment,” he emphasizes.

How is the diagnosis made?

The diagnosis will be made by the otorhinolaryngologist based on the history, the clinical examination (otoscopy and otomicroscopy), while, if otorrhea is present, culture of the secretion may also be needed, in order to determine the causative factor.

What is the treatment for otitis externa?

“With the appearance of the first symptoms, we start with the administration of analgesics to combat the pain. In addition, it is important to avoid the causative factors in the first place, with the main precaution being to avoid wetting.

If the infection is mild, symptoms usually improve within the first two days, while most ear infections clear up on their own within one to two weeks. But if the symptoms persist, we must consult our doctor and proceed with the appropriate treatment, depending on the underlying cause of the infection.

Treatment is easy and lasts seven to ten days if started early, usually with topical treatment in the form of drops, which may contain an antibiotic and/or corticosteroid or antifungal, depending on the microbe responsible.

In some cases, when the infection has progressed enough to block the ear canal, it may be necessary to place a small gauze pad soaked in medicine in it. In exceptional cases, either when the inflammation has been neglected, or when there are serious predisposing factors, such as the diabetes we mentioned above, or if there is no improvement with the above treatment, the administration of oral antibiotics, and less often hospitalization, may be required,” he explains.

Instructions for protecting the ears in the summer:

“To avoid unpleasant surprises, there are some guidelines we can follow to safeguard our holidays:
• We perform a preventive cleaning of the ears at a specialist otorhinolaryngologist, every year before the summer season so that water does not get trapped in the external auditory canal.
• We carefully choose the sea area or the pool where we will swim and avoid those with limited or defective renewal and disinfection of the water, as in such waters a bacterium called Pseudomonas aeruginosa “frequents”.
• We avoid using a cotton swab or foreign body before or after swimming to clean the ear, so as not to cause irritation or injury, as nature has provided and there is a self-cleaning mechanism. All we achieve by using the swab is to injure the external auditory canal and push the wax inside. It is better to prefer a clean towel or cotton, as far as our finger reaches, and we can instill drops of pure alcohol or acetic acid solution into the external auditory canal, as long as the tympanic membrane is intact and does not have ventilation cannulas. We can also protect our ears with silicone earplugs while swimming or enjoying water sports.
• We avoid diving from a height to avoid the pressure to which our ears are exposed.
• We avoid excessive use of air conditioning.
• We avoid ear injuries due to atmospheric pressure. In cases where we have sensitive ears and want to travel by plane, it is good to drink water often or chew gum during the flight.
• We protect our ears from loud sounds. Especially in the summer when we go to many concerts and musical performances, it is good to choose a place where the sound is not deafening, that is, away from the speakers.”

The Metropolitan Hospital has a model, fully equipped and organized Otorhinolaryngology Clinic, with a highly trained scientific and nursing staff and advanced technology equipment, which is constantly available for patients.

The Clinic has an audiological, neurotological and endoscopic laboratory, immediately offering the necessary diagnosis to the patients and carrying out checks on all ages (even infants), but also other tests, such as vertigo research, nose and larynx endoscopies, invasive endoscopies and generally all modern exams in the specialty.
As far as children are concerned, it is worth noting that the otolaryngology Clinic of the Metropolitan Hospital has extensive experience in the diagnosis and treatment of pediatric otolaryngological diseases.