Acute Otitis Externa
NHS Borders clinical guidelines
Warning
History
Acutely painful ear +/- discharge +/- muffled hearing.
Clinical Findings
Inflamed ear canal with pus/debris.
Management
- Water precautions/ avoid cotton buds/ in ear headphones.
- Treat topically with Sofradex 3 drops X3/day for 1 week or Otomise 1 spray X3/day for 1 week with GP follow up if not improving.
- If canal completely occluded can insert otowick which should be removed 2-3 days later.
- If severe - for urgent ENT clinic referral.
- If associated cranial nerve palsies discuss with ENT same day.
- Take microbiology swabs if resistant to initial topical treatment or in immunocompromised patients.