Otitis externa - Acute

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). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

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