MANAGMENT OF OTITIS EXTERNA

Abstract

Upale vanjskog uha (lat. otitis externa, OE) česta su patologija s kojom se pacijenti obraćaju liječniku. Stoga je potrebno da liječnici dobro poznaju kliničke entitete koji čine upale vanjskog uha, kao i odgovarajuće diferencijalne dijagnoze. Najčešće se pod pojmom vanjskog otitisa podrazumijeva difuzna upala zvukovoda, no u širem smislu ovdje spadaju i lokalizirani oblici upala zvukovoda te upale uške. Temelj liječenja difuznog oblika OE-a čini odgovarajuća lokalna terapija, a preduvjet za njezinu djelotvornost je dobra toaleta zvukovoda. Svaki liječnik trebao bi znati učiniti toaletu zvukovoda te postaviti oblog radi smanjenja edema u težim upalama. Naime, u slučaju jačih edema, kapi ne prodiru u kanal i ostaju nedjelotvorne. U lokalnoj terapiji najčešće se koriste antimikrobni pripravci te protuupalne i zakiseljavajuće tvari. Svakako je pri obradi pacijenta ključna dobra procjena težine bolesti. Nekomplicirane forme difuznog otitisa može rješavati liječnik primarne zdravstvene zaštite. Međutim, u slučaju neadekvatnog terapijskog odgovora te pri sumnji na komplikacije, pacijenta treba uputiti na specijalističku obraduExternal otitis is a common condition for which patients seek medical assistance. Thus it is essential for physicians to be familiar with clinical entities that comprise external otitis, as well as other pathologies that have similar symptoms. In the majority of cases, external otitis refers to a diffuse inflammation of the external auditory meatus. However, the entity of external otitis also includes localised forms of meatal inflammation, as well as auricular infections. The basis of therapy of any diffuse meatal infection is adequate local treatment and its prerequisite is a good aural toilet. Any physician should be able to perform aural toilet, but also introduce a wick in cases of intense canal swelling because in such cases ear drops remain ineffective. In local therapy, antimicrobial substances are most commonly used, along with anti-inflammatory and acidifying agents. While evaluating a patient, adequate assessment of disease severity is crucial. Uncomplicated forms of external otitis can be treated by a general practitioner. On the other hand, in cases of inadequate therapeutic response as well as any suspicion of complications, a further specialist workup is advised