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OTITIS EXTERNA AND DIVING Or Swimmers Ear Otitis Externa  External ear infection  2nd most common diving medical problem  Cause – Bacteria normally found in ear canal – NOT from bacteria in water Otitis Externa  With frequent immersion: – Water swells the cells lining the ear canal – Cells pull apart – Surface bacteria get underneath skin – PH change from slightly acidic to base – Warm, moist environment for growth Otitis Externa  Symptoms – Itchy ear canal – Thin, white discharge – Pain/inflamation – Lymph node swelling/pain – Pain with moving jaw Otitis Externa  Prevention – Topical ear solution (Bausch & Lomb)  2% acetic acid/aluminum acetate  Acid – retards bacterial growth  Astringent – draws excess water out of cells – Use at least twice daily – Solution must stay in 5 minutes* Otitis Externa  Prevention – Avoid cerumen buildup  Periodic flush with water  Do NOT use Q-tips  OTC solutions – Avoid alcohol-based drops  Irritating to ear canal  Destroys protective barrier Otitis Externa  Treatment – Requires physician evaluation – Cleansing of external ear canal – Topical antibiotics – Systemic antibiotics – severe cases – Pain medication – No diving for 5-7 days