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Asociación Colombiana de Otorrinolaringología y Cirugía de Cabeza y cuello, Maxilofacial y Estética Facial (ACORL)

2024, Número 3

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Acta de Otorrinolaringología CCC 2024; 52 (3)


Guía para el diagnóstico y el tratamiento de la otitis externa aguda

Bello-Avena VE, González-Orozco A, Borbón-Vélez MC

Idioma: Español
Referencias bibliográficas: 76
Paginas: 334-350
Archivo PDF: 599.07 Kb.


FRAGMENTO

Introducción: La otitis externa aguda (OEA) se define como una inflamación difusa del conducto auditivo externo que puede extenderse al pabellón auricular o a la membrana timpánica. En la mayoría de los casos (98%) su origen es bacteriano y los patógenos más comunes son Pseudomonas aeruginosa y Staphylococcus aureus, pudiendo ser polimicrobiana; el tratamiento está basado en ototópicos pero en algunos casos debe complementarse con manejo sistémico. La exposición al agua y el sudor, dispositivos de jabón o gotas alcalinas, infecciones dermatológicas, traumatismos locales y reacciones alérgicas pueden contribuir a su patogénesis. Las estrategias preventivas incluyen evitar acúmulo de agua y humedad en el canal auditivo externo, manteniendo la barrera natural cutánea sana.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA, et al. Clinical Practice Guideline: Acute Otitis Externa.Otolaryngol Head Neck Surg. 2014;150(1 Suppl):S1-S24. doi: 10.1177/0194599813517083

  2. Asociación Colombiana de Otorrinolaringología, Cirugía de Cabeza y Cuello, Maxilofacial y Estética Facial (ACORL). GuíasOficiales ACORL basadas en la evidencia: Guía para el diagnóstico y tratamiento de la Otitis Externa Aguda; 2016 [consultada el19 de junio de 2024]. Disponible en: https://www.acorl.org.co/resources/imagenes/visitante/medico/apoyo-al-ejercicio-profesional/guias-acorl/GUIAS_ACORL_Otitis_externa_aguda.pdf

  3. Roland PS, Stroman DW. Microbiology of acute otitis externa. Laryngoscope. 2002;112(7 Pt 1):1166-77. doi: 10.1097/00005537-200207000-00005

  4. Dibb WL. Microbial aetiology of otitis externa. J Infect. 1991;22(3):233-239. doi: 10.1016/s0163-4453(05)80004-0

  5. Agius AM, Pickles JM, Burch KL. A prospective study of otitis externa. Clin Otolaryngol Allied Sci 1992;17(2):150-154. doi:10.1111/j.1365-2273.1992.tb01063.x

  6. Cassisi N, Cohn A, Davidson T, Witten BR. Diffuse otitis externa: clinical and microbiologic findings in the course of a multicenterstudy on a new otic solution. Ann Otol Rhinol Laryngol Suppl. 1977;86(3, Suppl 39):1-16. doi: 10.1177/00034894770863s201

  7. Clark WB, Brook I, Bianki D, Thompson DH. Microbiology of otitis externa. Otolaryngol Head Neck Surg. 1997;116(1):23-25. doi:10.1016/S0194-59989770346-2

  8. Jones RN, Milazzo J, Seidlin M. Ofloxacin otic solution for treatment of otitis externa in children and adults. Arch Otolaryngol HeadNeck Surg. 1997;123(11):1193-1200. doi: 10.1001/archotol.1997.01900110047007

  9. Pistorius B, Westburry K, Drehobl M, Williams D, Bock T, Lucente FE, et al. Prospective, randomized, comparative trial ofciprofloxacin otic drops, with or without hydrocortisone, vs. polymyxin B-neomycin-hydrocortisone otic suspension in the treatmentof acute diffuse otitis externa. Infect Dis Clin Pract. 1999;8(8):387-395.

  10. Arshad M, Khan NU, Ali N, Afridi NM. Sensitivity and spectrum of bacterial isolates in infectious otitis externa. J Coll PhysiciansSurg Pak 2004;14(3):146-149.

  11. Manolidis S, Friedman R, Hannley M, Roland PS, Matz G, Rybak L, et al. Comparative efficacy of aminoglycoside versusfluoroquinolone topical antibiotic drops. Otolaryngol Head Neck Surg. 2004;130(3 Suppl):S83-8. doi: 10.1016/j.otohns.2003.12.006

  12. Hajioff D. Otitis externa. Clin Evid. 2004;(12):755-763.

  13. Halpern MT, Palmer CS, Seidlin M. Treatment patterns for otitis externa. J Am Board Fam Pract. 1999;12(1):1-7. doi: 10.3122/15572625-12-1-1

  14. McCoy SI, Zell ER, Besser RE. Antimicrobial prescribing for otitis externa in children. Pediatr Infect Dis J. 2004;23(2):181-183.10.1097/01.inf.0000109958.65053.4e

  15. Levy SB. The Antibiotic Paradox: How the Misuse of Antibiotic Destroys Their Curative Powers. Cambridge, MA: Perseus Publishing; 2002.

  16. McCormick AW, Whitney CG, Farley MM, Lynfield R, Harrison LH, Bennett NM, et al. Geographic diversity and temporal trends ofantimicrobial resistance in Streptococcus pneumoniae in the United States. Nat Med. 2003;9(4):424-430. doi: 10.1038/nm839

  17. Nussinovitch M, Rimon A, Volovitz B, Raveh E, Prais D, Amir J. Cotton-tip applicators as a leading cause of otitis externa. Int JPediatr Otorhinolaryngol. 2004;68(4):433-435. doi: 10.1016/j.ijporl.2003.11.014

  18. Goffin FB. pH and otitis externa. Arch Otolaryngol. 1963;77:363-364. doi: 10.1001/archotol.1963.00750010377005

  19. Martinez Devesa P, Willis CM, Capper JW. External auditory canal pH in chronic otitis externa. Clin Otolaryngol Allied Sci.

  20. 2003;28(4):320-324. 10.1046/j.1365-2273.2003.00713.x20. Hirsch BE. Infections of the external ear. Am J Otolaryngol. 1992;13(3):145-155. doi: 10.1016/0196-0709(92)90115-a

  21. Russell JD, Donnelly M, McShane DP, Alun-Jones T, Walsh M. What causes acute otitis externa? J Laryngol Otol. 1993;107(10):898-901. doi: 10.1017/s0022215100124739

  22. Hoadley AW, Knight DE. External otitis among swimmers and nonswimmers. Arch Environ Health. 1975;30(9):445-448. doi:10.1080/00039896.1975.10666747

  23. Steuer MK, Beuth J, Hofstädter F, Pröbster L, Ko HL, Pulverer G, et al. Blood group phenotype determines lectin-mediated adhesionof Pseudomonas aeruginosa to human outer ear canal epithelium. Zentralbl Bakteriol. 1995;282(3):287-95. doi: 10.1016/s0934-8840(11)80129-5

  24. Bojrab DI, Bruderly T, Abdulrazzak Y. Otitis externa. Otolaryngol Clin North Am. 1996;29(5):761-782.

  25. Nichols AW. Nonorthopaedic problems in the aquatic athlete. Clin Sports Med. 1999;18(2):395-411. doi: 10.1016/s0278-5919(05)70154-x

  26. Raymond L, Spaur WH, Thalmann ED. Prevention of divers’ ear. Br Med J. 1978;1(6104):48. doi: 10.1136/bmj.1.6104.48-d

  27. Sander R. Otitis externa: a practical guide to treatment and prevention. Am Fam Physician. 2001;63(5):927-936, 941-922.

  28. Hannley MT, Denneny JC III, Holzer SS. Use of ototopical antibiotics in treating 3 common ear diseases. Otolaryngol Head NeckSurg. 2000;122(6):934-940. doi: 10.1067/mhn.2000.107813

  29. Shikiar R, Halpern MT, McGann M, Palmer CS, Seidlin M. The relation of patient satisfaction with treatment of otitis externa toclinical outcomes: development of an instrument. Clin Ther. 1999;21(6):1091-1104. doi: 10.1016/S0149-2918(99)80027-7

  30. Rosenfeld RM, Brown L, Cannon CR, Dolor RJ, Ganiats TG, Hannley M, et al. Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surg. 2006;134(4 suppl):S4-S23. doi: 10.1016/S0194-5998(06)00266-X

  31. Guthrie RM, Bailey BJ, Witsell DL, Shulman ST, Harris JAS, Dohar JE, et al. Diagnosis and treatment of acute otitis externa: aninterdisciplinary update. Ann Otol Rhinol Laryngol. 1999;17:2-23.

  32. Rowlands S, Devalia H, Smith C, Hubbard R, Dean A. Otitis externa in UK general practice: a survey using the UK General PracticeResearch Database. Br J Gen Pract. 2001;51(468):533-8.

  33. Lucente FE, Lawson W, Novick NL. External Ear. Philadelphia, PA: WB Saunders Co; 1995.

  34. Raza SA, Denholm SW, Wong JC. An audit of the management of otitis externa in an ENT casualty clinic. J Laryngol Otol.1995;109(2):130-133. doi: 10.1017/s0022215100129469

  35. Timon CI, O’Dwyer T. Diagnosis, complications, and treatment of malignant otitis externa. Ir Med J. 1989;82(1):30–31.

  36. Prasad KC, Prasad SC, Mouli N, Agarwal S. Osteomyelitis in the head and neck. Acta Otolaryngol. 2007;127(2):194–205. doi:10.1080/00016480600818054

  37. Phillips P, Bryce G, Shepherd J, Mintz D. Invasive external otitis caused by Aspergillus. Rev Infect Dis. 1990;12(2):277–281. doi:10.1093/clinids/12.2.277

  38. Hern JD, Almeyda J, Thomas DM, Main J, Patel KS. Malignant otitis externa in HIV and AIDS. J Laryngol Otol. 1996;110(8):770–775. doi: 10.1017/s0022215100134929

  39. Wolff LJ. Necrotizing otitis externa during induction therapy for acute lymphoblastic leukemia. Pediatrics. 1989;84(5):882–885.

  40. Roland PS, Smith TL, Schwartz SR, Rosenfeld RM, Ballachanda B, Earll JM, et al. Clinical practice guideline: cerumen impaction.Otolaryngol Head Neck Surg. 2008;139(3 suppl 2):S1–S21. doi: 10.1016/j.otohns.2008.06.026

  41. Kaur R, Mittal N, Kakkar M, Aggarwal AK, Mathur MD. Otomycosis: a clinicomycologic study. Ear Nose Throat J. 2000;79(8):606–609.

  42. Jereczek-Fossa BA, Zarowski A, Milani F, Orecchia R. Radiotherapy-induced ear toxicity. Cancer Treat Rev. 2003;29(5):417-430.doi: 10.1016/s0305-7372(03)00066-5

  43. Schechter NL, Berde CM, Yaster M. Pain in Infants, Children, and Adolescents. Baltimore, MD: Williams & Wilkins; 1993.

  44. Joint Commission on Accreditation of Health Care Organizations [Internet]. Pain: Current Understanding of Assessment, Managementand Treatments. National Pharmaceutical Council & JCAHO; 2001 [consultado el 19 de junio de 2024]. Disponible en http://www.JCAHO.org

  45. American Academy of Pediatrics; Committee on Psychosocial Aspects of Child and Family Health; Task Force on Pain in Infants,Children, and Adolescents. The assessment and management of acute pain in infants, children, and adolescents. Pediatrics.2001;108(3):793-797. doi: 10.1542/peds.108.3.793

  46. Bieri D, Reeve RA, Champion GD, Addicoat L, Ziegler JB. The Faces Pain Scale for the self-assessment of the severity of painexperienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain. 1990;41(2):139–150. doi: 10.1016/0304-3959(90)90018-9

  47. Powell CV, Kelly AM, Williams A. Determining the minimum clinically significant difference in visual analog pain score for children.Ann Emerg Med. 2001;37(1):28–31. doi: 10.1067/mem.2001.111517

  48. Loesser JD. Bonica’s Management of Pain. 3.a edición. Baltimore, MD: Lippincott Williams & Wilkins; 2001.

  49. Valencia CG, Valencia PG. Diclofenaco potásico vs placebo en otitis externa aguda: estudio doble ciego, comparativo. Invest Med Int.1987;14:56-60.

  50. Zeltzer LK, Altman A, Cohen D, LeBaron S, Munuksela EL, Schechter NL. American Academy of Pediatrics Report of theSubcommittee on the Management of Pain Associated with Procedures in Children with Cancer. Pediatrics 1990;86(5):826-831.

  51. van Balen FA, Smit WM, Zuithoff NP, Verheij TJ. Clinical efficacy of three common treatments in acute otitis externa in primary care:randomised controlled trial. BMJ 2003;327(7425):1201-1205. doi: 10.1136/bmj.327.7425.1201

  52. Slack RW. A study of three preparations in the treatment of otitis externa. J Laryngol Otol 1987;101(6):533–535. doi: 10.1017/s0022215100102178

  53. Psifidis A, Nikolaidis P, Tsona A, et al. The efficacy and safety of local ciprofloxacin in patients with external otitis: a randomizedcomparative study. Mediterranean J Otol Audiol. 2005;1:20–23.

  54. Kaushik V, Malik T, Saeed SR. Interventions for acute otitis externa. Cochrane Database Syst Rev. 2010(1):CD004740. doi:10.1002/14651858.CD004740.pub2

  55. Pottumarthy S, Fritsche TR, Sader HS, Stilwell MG, Jones RN. Susceptibility patterns of Streptococcus pneumoniae isolates in NorthAmerica (2002-2003): contemporary in vitro activities of amoxicillin/clavulanate and 15 other antimicrobial agents. Int J AntimicrobAgents. 2005;25(4):282–289. doi: 10.1016/j.ijantimicag.2004.12.001

  56. Doern GV. Antimicrobial resistance with Streptococcus pneumoniae in the United States. Semin Respir Crit Care Med. 2000;21(4):273–284. doi: 10.1055/s-2000-9863

  57. Schrag SJ, McGee L, Whitney CG, Beall B, Craig AS, Choate ME, et al. Emergence of Streptococcus pneumoniae with very-high-level resistance to penicillin. Antimicrob Agents Chemother 2004;48(8):3016–3023. doi: 10.1128/AAC.48.8.3016-3023.2004

  58. Weber PC, Roland PS, Hannley M, Friedman R, Manolidis S, Matz G, et al. The development of antibiotic resistant organisms withthe use of ototopical medications. Otolaryngol Head Neck Surg 2004;130(3 suppl):S89–S94. doi: 10.1016/j.otohns.2003.12.009

  59. Zikk D, Rapoport Y, Redianu C, Shalit I, Himmelfarb MZ. Oral ofloxacin therapy for invasive external otitis. Ann Otol RhinolLaryngol. 1991;100(8):632–637. doi: 10.1177/000348949110000806

  60. Mösges R, Nematian-Samani M, Hellmich M, Shah-Hosseini K. A meta-analysis of the efficacy of quinolone containing otics incomparison to antibiotic-steroid combination drugs in the local treatment of otitis externa. Curr Med Res Opin. 2011;27(10):2053-2060. doi: 10.1185/03007995.2011.616192

  61. Smith IM, Keay DG, Buxton PK. Contact hypersensitivity in patients with chronic otitis externa. Clin Otolaryngol Allied Sci.1990;15(2):155-158. doi: 10.1111/j.1365-2273.1990.tb00449.x

  62. England RJ, Homer JJ, Jasser P, Wilde AD. Accuracy of patient self-medication with topical eardrops. J Laryngol Otol. 2000;114(1):24-25. doi: 10.1258/0022215001903834

  63. Agius AM, Reid AP, Hamilton C. Patient compliance with short-term topical aural antibiotic therapy. Clin Otolaryngol Allied Sci.1994;19(2):138-141. doi: 10.1111/j.1365-2273.1994.tb01198.x

  64. Grandis JR, Branstetter 4th BF, Yu VL. The changing face of malignant (necrotising) external otitis: clinical, radiological, andanatomic correlations. Lancet Infect Dis. 2004;4(1):34-39. doi: 10.1016/s1473-3099(03)00858-2

  65. Smathers CR. Chemical treatment of external otitis. South Med J. 1977;70(5):543-545. doi: 10.1097/00007611-197705000-00011

  66. Russell PT, Church CA, Jinn TH, Kim DJ, John EO, Jung TT. Effects of common topical otic preparations on the morphology ofisolated cochlear outer hair cells. Acta Otolaryngol. 2001;121(2):135-139. doi: 10.1080/000164801300043208

  67. Jinn TH, Kim PD, Russell PT, Church CA, John EO, Jung TT. Determination of ototoxicity of common otic drops using isolatedcochlear outer hair cells. Laryngoscope. 2001;111(12):2105-2108. doi: 10.1097/00005537-200112000-00004

  68. Roland PS, Rybak L, Hannley M, Matz G, Stewart MG, Manolidis S, et al. Animal ototoxicity of topical antibiotics and the relevanceto clinical treatment of human subjects. Otolaryngol Head Neck Surg. 2004;130(3 suppl):S57-S78. doi: 10.1016/j.otohns.2003.12.008

  69. Rakover Y, Keywan K, Rosen G. Safety of topical ear drops containing ototoxic antibiotics. J Otolaryngol. 1997;26(3):194-196.

  70. Abello P, Vinas JB, Vega J. Topical ototoxicity: review over a 6-year period [in Spanish]. Acta Otorrinolaringol Esp. 1998;49(5):353-356.

  71. Lieberthal AS, Carroll AE, Chonmaitree T, Ganiats TG, Hoberman A, Jackson MA, et al. Clinical practice guideline: the diagnosisand management of acute otitis media. Pediatrics. 2013;131(3):e964-999. doi: 10.1542/peds.2012-3488

  72. Myer CM III. The evolution of ototopical therapy: from cumin to quinolones. Ear Nose Throat J. 2004;83(1 suppl):9-11.

  73. Marzo SJ, Leonetti JP. Invasive fungal and bacterial infections of the temporal bone. Laryngoscope. 2003;113(9):1503-1507. doi:10.1097/00005537-200309000-00016

  74. Sood S, Strachan DR, Tsikoudas A, Stables GI. Allergic otitis externa. Clin Otolaryngol Allied Sci. 2002;27(4):233-236. doi:10.1046/j.1365-2273.2002.00584.x

  75. Rutka J. Acute otitis externa: treatment perspectives. Ear Nose Throat J. 2004;83(9 suppl 4):20-21; discussion 21-2.

  76. Devos SA, Mulder JJ, van der Valk PG. The relevance of positive patch test reactions in chronic otitis externa. Contact Dermatitis.2000;42(6):354-355.




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