Otitis externa classification: Difference between revisions
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===Chronic Otitis Externa=== | ===Chronic Otitis Externa=== | ||
*Otitis externa is considered chronic | *Otitis externa is considered chronic in cases that persist greater than 3 months with treatment.<ref name="pmid24421666">{{cite journal |vauthors=Hui CP |title=Acute otitis externa |journal=Paediatr Child Health |volume=18 |issue=2 |pages=96–101 |year=2013 |pmid=24421666 |pmc=3567906 |doi= |url=}}</ref> | ||
** | **It is usually diagnosed in cases which [[antibiotic]] therapy does not alleviate symptoms. | ||
===Malignant Necrotizing Otitis Externa=== | ===Malignant Necrotizing Otitis Externa=== | ||
Revision as of 20:38, 6 August 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
Otitis externa is classified as acute, chronic, or malignant based on the duration of the disease, diffusion of the infection, and the severity of symptoms.
Classification
Otitis externa is classified by duration, diffusion, and symptom severity.
Acute Otitis Externa
- Otitis externa is characterized as "acute" if the following conditions are satisfied:[1]
- Hearing loss is not usually associated with acute presentations of otitis externa.[1]
- Acute otitis externa is localized to the ear canal and is not characterized by diffusion of infection throughout the ear and head.
Chronic Otitis Externa
- Otitis externa is considered chronic in cases that persist greater than 3 months with treatment.[1]
- It is usually diagnosed in cases which antibiotic therapy does not alleviate symptoms.
Malignant Necrotizing Otitis Externa
- Acute otitis externa becomes reclassified as malignant and necrotizing when the infectious pathogen diffuses from the ear canal and infects the temporal bones, as well as bones in the ear adjacent to the canal, leading to damage and degradation.[3][4]
- It is usually caused by the bacterial pathogen responsible for the acute variant, usually Pseudomonas aeruginosa.
- Otitis externa becomes malignant when the patient is immunocompromised.
- It usually occurs in acute otitis externa patients with diabetes or undergoing chemotherapy, leading to reduced ability to counter the spread of the pathogen.
- Malignant otitis externa will usually manifest with the following symptoms:
- Severe otalgia and otorrhea that is not responsive to treatment.
- Granulated tissue in the ear canal
- Intracranial and neck complications:
- Fever
- Nerve damage in the head and neck.
- Osteitis
- Lymphadenitis
- Difficulty speaking or swallowing.
- Facial palsy
- Treatment of malignant otitis externa requires therapy targeting the pathogen as well as the source for immunocompromisation.
References
- ↑ 1.0 1.1 1.2 1.3 Hui CP (2013). "Acute otitis externa". Paediatr Child Health. 18 (2): 96–101. PMC 3567906. PMID 24421666.
- ↑ Schaefer P, Baugh RF (2012). "Acute otitis externa: an update". Am Fam Physician. 86 (11): 1055–61. PMID 23198673.
- ↑ Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.
- ↑ "Malignant otitis externa: MedlinePlus Medical Encyclopedia".