1、Disease of the External EarOtitis Externa Bacterial infection of external auditory canal Categorized by time courseAcuteSubacuteChronicAcute Otitis Externa(AOE)“Swimmers ear”Preinflammatory stage Acute inflammatory stage Mild Moderate SeverePreinflammatory Stage Symptoms:pruritus and sense of fullne
2、ss Signs:mild edemaAcute Otitis Externa(AOE)Progressive infection Symptoms Pain Increased pruritus Signs Erythema Increasing edema Canal debris,dischargeAcute Otitis Externa(AOE)Severe pain,worse with ear movement Signs Lumen obliteration Purulent otorrhea Involvement of periauricular soft tissueAcu
3、te Otitis Externa(AOE)Treatment Most common pathogens P.aeruginosa（绿脓杆菌）S.aureus(金黄色葡萄球菌)Four principles Frequent canal cleaning Topical antibiotics Pain control Instructions for preventionAcute Otitis Externa(AOE)Chronic Otitis Externa(COE)Chronic inflammatory process Persistent symptoms(2 months)B
4、acterial,fungal,dermatological etiologiesSymptoms Unrelenting pruritus Mild discomfort Dryness of canal skinChronic Otitis Externa(COE)Signs Asteatosis（皮脂腺分泌减少）Dry,flaky skin Hypertrophied skin Mucopurulent otorrhea(occasional)Chronic Otitis Externa(COE)Treatment Similar to that of AOE Topical antib
5、iotics,frequent cleanings Topical Steroids Surgical intervention Failure of medical treatment Goal is to enlarge and resurface the EACChronic Otitis Externa(COE)Furunculosis Acute localized infection Lateral 1/3 of posterosuperior canal Obstructed ear canal Pathogen:S.aureus(金黄色葡萄球菌)Symptoms Localiz
6、ed pain Pruritus Hearing loss(if lesion occludes canal)FurunculosisSigns Edema Erythema Tenderness Occasional fluctuanceFurunculosisTreatment Local heat Analgesics Oral anti-staphylococcal antibiotics Incision and drainage reserved for localized abscess IV antibiotics for soft tissue extensionFurunculosisThanks！
