Prognosis
Patients with uncomplicated diffuse otitis externa usually respond to treatment. Between 65% and 90% of patients have clinical resolution within 7-10 days, regardless of the agent used.[1]
The mortality rate of necrotizing otitis externa has decreased over the years from 50% to 0%-15%.[50] Facial nerve paralysis is a poor prognostic factor, and its presence indicates the need for longer treatment.[50] In such patients, recovery of the function of the facial nerve might not occur. Aspergillus infection and dural enhancement of the middle cranial fossa and foramen magnum on magnetic resonance imaging are other poor prognostic indicators in patients with necrotizing otitis externa.[50]
Predisposing factors
A search for predisposing factors is helpful and sometimes necessary in patients with recurrent acute otitis externa. Patients should be educated to avoid the use of cotton-tipped applicators or other foreign objects. Patients who report ear pain and infections after swimming should use occlusive ear plugs. Underlying dermatitis or other skin disorders should be attended to and treated with topical steroids whenever needed. A search for possible allergy to certain ear drops and/or hearing aid components should be considered.
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