Otitis Externa
Overview
A practical ENT-focused approach to the patient presenting with severe ear pain, itching, discharge, or obstruction of the external auditory canal. Otitis externa is not just “ear drops and goodbye.” Treatment succeeds when three things are done properly: the canal is cleaned, the topical agent is chosen according to the tympanic membrane status and clinical pattern, and the medication actually reaches the deep canal. In a diabetic or immunocompromised patient with resistant nocturnal pain or canal granulation, the mindset must change immediately: necrotizing / malignant otitis externa must be considered until proven otherwise.
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