Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig; Department of Pediatrics, University Hospital Carl Gustav Carus Dresden, TU Dresden; Institute of General Practice, Technical University of Munich; HNO-Praxis Lundershausen, Erfurt.
Dtsch Arztebl Int. 2019 Mar 29;116(13):224-234. doi: 10.3238/arztebl.2019.0224.
Otitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms.
This review is based on publications retrieved by a selective search of the pertinent literature.
The treatment of acute otitis media consists of anal- gesia, cleansing of the external auditory canal, and the appli- cation of antiseptic and antimicrobial agents. Local antibiotic and corticosteroid preparations have been found useful, but there have been no large-scale randomized controlled trials of their use. Topical antimicrobial treatments lead to a higher cure rate than placebo, and corticosteroid preparations lessen swelling, erythema, and secretions. Oral antibiotics are indi- cated if the infection has spread beyond the ear canal or in patients with poorly controlled diabetes mellitus or immuno- suppression. Chronic otitis externa is often due to an under- lying skin disease. Malignant otitis externa, a destructive infection of the external auditory canal in which there is also osteomyelitis of the petrous bone, arises mainly in elderly diabetic or immunosuppressed patients and can be life- threatening.
With correct assessment of the different types of otitis externa, rapidly effective targeted treatment can be initi- ated, so that complications will be avoided and fewer cases will progress to chronic disease.
外耳炎的终生患病率为 10%，可表现为急性、慢性和坏死性。
本综述基于对相关文献进行选择性检索后获得的出版物。
急性中耳炎的治疗包括止痛、清洁外耳道，以及应用防腐抗菌药物。局部抗生素和皮质类固醇制剂已被证明有效，但尚未有关于其使用的大规模随机对照试验。局部抗菌治疗比安慰剂的治愈率更高，皮质类固醇制剂可减轻肿胀、红斑和分泌物。如果感染已扩散至耳道以外，或患者患有糖尿病控制不佳或免疫抑制，可口服抗生素。慢性外耳炎通常由潜在的皮肤病引起。恶性外耳炎是一种破坏性的外耳道感染，其中也有岩骨骨髓炎，主要发生在老年糖尿病或免疫抑制患者中，可危及生命。
通过正确评估不同类型的外耳炎，可以迅速有效地进行针对性治疗，从而避免并发症，并减少向慢性疾病发展的病例。
