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[Chronic recurrent otitis externa. Excessive ear hygienic care can have sequelae].

Numerous factors may be involved in the development of chronic recurrent otitis externa: altered pH of the cerumen, increased susceptibility to contact allergens (e.g. nickel ear-rings) in atopic patients, the use of instruments for cleaning out the auditory canal, the presence of a foreign body, congential narowing of the auditory canal, or systemic diseases (in particular diabetes mellitus). For diagnostic purposes, the use of the otoscope is mandatory, and swabs to determine the presence of bacteria or fungi are to be recommended. Treatment is dictated by the clinical picture presenting, and may comprise the local application of antibiotic cortisone containing or antimycotic preparations and temponade of the auditory canal (acute inflammatory phase) or pH-stabilizing lotions (chronic dry inflammatory phase) with the aim of ameliorating the frequently highly troublesome pruritus.