Chronic otitis externa

Chronic otitis externa is defined as inflammation of the external ear canal that lasts for 3 months or longerHajioff, 2015. It is typically caused by contact dermatitis, atopic dermatitis or seborrhoeic dermatitis, and can be prevented by treating the dermatitis. For a summary of management, including topical corticosteroid and emollient recommendations, see the Dermatology guidelines.

Also consider other noninfective causes of chronic otitis externa, such asKesser, 2011:

• psoriasis
• autoimmune conditions
• hearing aid mouldsHawke, 1984
• allergy to antimicrobial ear drops.

Infective chronic otitis externa is more likely to have a fungal aetiology than acute otitis externaHawke, 1984. Obtain swab samples for culture and susceptibility testing to guide the choice of antimicrobial ear drop.

If chronic otitis externa does not resolve, consider referral to an otolaryngologist or a dermatologistMylanus, 2008.