Sandbox:Otitis externa physical examination

Otitis externa Microchapters
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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.

Physical Examination

HEENT and Neck

• The following physical exam findings in the ear canal are indicative of otitis externa:
  • Erythema and edema.
  • Tenderness of the tragus and auricle.
  • Cellulitis of the auricle and ear canal.
  • Otorrhea
  • Granulation tissue
  • Stenosis of the ear canal.
  • Buildup of mycotic debris.
  • Lack of cerumen.
• In the neck, lymphadenitis may be present in acute otitis externa.
• In malignant necrotizing otitis externa, the patient may present signs of trismus and partial facial palsy.

Appearance of the Patient

• For acute otitis externa, the patient can appear ill if the cause is infectious and is accompanied by fever.
• Patients with chronic otitis externa are usually well-appearing.
• Malignant necrotizing otitis externa patients are usually ill-appearing due to the accompanying fever and facial palsies.

Key Examples of Otitis Externa Physical Findings

• 

  A severe case of acute otitis externa. Note the narrowing of the external auditory channel, the prominent amounts of exudate and swelling of the auricle. Case presented by James Heilman, MD.

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  A mild case of otitis externa. Case presented by Klaus D. Peter.