[Diagnosis and therapy of infectious otitis externa. An overview for the non-ENT physician]

Knowledge of the different clinical manifestations of inflammation caused by specific infectious agents of the external ear canal and the auricle makes a successful empirical therapy possible. Initial therapy should always consist of local treatment modalities including repeated cleansing of the aural canal and insertion of a cotton wick carrying local medication. Major advancement of systemic therapy of bacterial external otitis has been obtained by the availability of the new Gyrase-inhibitors (Fluoroquinolones). These antibiotic drugs possess--given orally--strong activity against the entire spectrum of etiologic bacteria and are effective in the difficult to treat malignant external otitis. In systemic therapy of Zoster oticus the antiviral substance Aciclovir can improve otalgia and auricular eruptions. Early Aciclovir treatment is advised in cases of Ramsay Hunt Syndrome to minimize permanent nerve damage.