EXTERNAL OTITIS: PATHOPHYSIOLOGY, MICROBIOLOGY, AND THERAPEUTIC MANAGEMENT

Abstract

External otitis (OE) is an acute or chronic inflammation of the external auditory canal, predominantly of bacterial etiology. This article aims to review external otitis, including its pathophysiology, microbiology, and therapeutic management. Factors such as excessive moisture and epithelial microtrauma are determinants in the genesis of the condition. Clinically, OE manifests as severe ear pain, a positive tragus sign, and diffuse edema on otoscopy. The diagnosis is essentially clinical, reserving imaging exams and cultures for refractory cases or suspected necrotizing external otitis in immunocompromised patients. Therapeutic management is based on cleaning the ear canal and applying topical agents, such as quinolones combined with corticosteroids, which have greater efficacy and a lower risk of systemic effects compared to oral antibiotic therapy. In conclusion, early diagnosis and appropriate topical treatment are cornerstones for clinical resolution and prevention of serious complications, such as osteomyelitis of the skull base.