Otitis externa - Acute

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to the referral standards and include:

  • Otalgia, hearing loss, otorrhoea, pruritic ear canal
  • History ear canal trauma e.g. cotton bud/hair pin use
  • Diabetic history
  • Examination findings of oedematous ear canal (TM may not be seen) and purulent otorrhoea
  • Tuning forks consistent with conductive or sensorineural loss

Interim/GP management

To refer a patient with this condition, please see the ENT clinic page for the full referral process and templates.

  • Protect ear from water exposure
  • Aural toilet (not syringing) if experienced and adequate equipment available
  • Tissue spear can be used for dry mopping
  • Topical antibiotic/steroid drops
  • Consider topical antifungal/steroid drops if fungal (e.g. spores)
  • If unresponsive to initial management, prescribe culture directed topical drops
  • If perforation present, use Ciloxan or consider locacorten vioform drops

For more information please see the Tasmanian Health Pathways website.

Emergency

If otalgia disproportionate with signs in diabetic patient non-responsive to topical therapy – refer immediately to ED to exclude skull base osteomyelitis

  If ear canal occluded by oedema / unable to clear discharge – refer immediately to ED

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment