Reviewed on : 28 Dec 2016

Reviewed by : Peter Dekker, Consultant ENT Surgeon

Expires : 28 Dec 2018

Assessment

Consider causes:

• otitis externa – mild/moderate/severe; bacterial or fungal
• otitis media with perforation
• cholesteatoma
• necrotising otitis externa

Management

• GP to examine ears and attempt to visualise tympanic membrane
• consider swab
• drops and/or antibiotics, see British National Formulary, section 12.1

Referral Threshold

• failure to resolve e.g. four weeks
• non-healing perforation
• if aural toilet is required
• if there is severe otitis externa, speak to the ENT doctor on call at UHCW to request an appointment at the daily ENT Emergency Clinic
• necrotising otitis externa requires ENT assessment (significant pain in an elderly diabetic, particularly bad at night)