Thursday Brief

With Covid 19 pandemic prevailing in the country for last 8 months, most of the people are working from home. Which means most of the times you are sitting in front of PC/Laptop and are using mobile phones. Most of the IT companies have voice connection through their internet network, and it become almost mandatory for employees to use headphones or any other listening devices, so that with least disturbance they can talk over the network with their colleagues, participate in video/zoom meetings etc etc.

Now the continuous use of earphones & other listening devices can become a cause of ear infection. The problem is these devices block air from entering the ears, which can lead to bacteria/fungal growth, then humidity in cities like Mumbai adding to the problem. The infection due to this can be itchy and painful in most of the cases. As per the ENT specialists the ear infections cases have gone up many fold.

In medical term this condition is called as OTITIS EXTERNA. It is also known as Swimmers’ ear.

Otitis externa is an infection of the external ear, a common condition that is mainly seen in primary care.

It is more common in younger ages and females, with a prevalence of around 1%. The incidence tends to be higher in hot and humid climates, and towards the end of summer.

Otitis externa typically affects the external auditory canal – the part of the ear via which sound waves travel to reach the membrane.

Any interruption in wax formation (eg. repeated water exposure), trauma to the canal (eg cotton buds) or blockage (eg debris) can disrupt the external auditory canal’s protective mechanisms, and lead to pathogen overgrowth and inflammation.

The skin becomes  swollen, tender, and warm, leading to debris and discharge accumulation. The narrowing of the canal, in combination with the accumulation of debris, leads to further entrapment of pathogens and propagating the infective process.

The main risk factors for otitis externa are those that interfere with the normal protective mechanisms of the external auditory canal:

Frequent water contact (e.g. swimmers and frequent hair washers),Humid environments and Local trauma (e.g. hearing aids, use of ear phones, or excessive use of cotton buds).

How Otitis Externa Occurs :

Naturally ear wax plays an important role to protect the outermost layer of the ear canal and protect the eardrum from dust and foreign particles.

The body has a mechanism to throw out the wax, but inflammation leads to build up of wax that is combination of dirt, sweat, oil, dead skin and hair.

The waxy build up is this an ideal ground for bacteria and fungus to grow.

The symptoms include pain, odour, discharge and itching.

Treatment- Generally local application helps, but when infection is severe then patients will need antibiotics or anti fungals  to get rid of the infection.

If this infection is neglected or not taken seriously then there are very good chances of even partial loss of hearing.

The mainstay of management in otitis externa involves prevention, aural toileting, and topical antibiotics.

No single topical antibiotic regime has been found to be superior, thus the antibiotic choice depends on the patient and doctor preference, local sensitivities and adverse reactions.

Steroid drops have been shown to be beneficial when there is evidence of canal inflammation. It acts to decrease the swelling (allowing the antibiotic to perforate) and reduce pain.

Doctors are advising to use hair dryer to dry ears instead of ear buds. They also advise that earphones and other listening devices should be sanitised on daily basis.

So crux of the matter is be sensible, and in present days do not use your earphones for continuous basis for longer time, as this may one of the causes for OTITIS EXTERNA.

Hope this information will be useful to you all.

Waiting for your comments/views/feedbacks.

Anil Malik

Mumbai, India

19^th November 2020