Approach to otitis externa

Objective: To provide family physicians with a practical evidence-based approach to management of otitis externa.

Sources of information: The approach described is based on MEDLINE and PubMed literature published between 1993 and 2023.

Main message: Otitis externa is diffuse inflammation of the external auditory canal and typically occurs from moisture exposure and trauma. Management focuses on eliminating infection, pain management, education, and preventing recurrence. The primary treatment of uncomplicated otitis externa is topical. Complicated presentations may require additional systemic therapy.

Conclusion: History taking and physical examination can help differentiate among acute, chronic, and necrotizing otitis externa. At-risk populations, typically those who are immunosuppressed, are more likely to develop necrotizing otitis externa and should be carefully monitored.