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Ear infection, outer - Complications of otitis externa

NHS Choices Medical Reference

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Complications associated with otitis externa are usually uncommon. However, the the following complications can sometimes occur.


Abscesses are usually painful, pus-filled growths that can form in and around the affected ear after an infection. They usually heal on their own but, in some cases, your GP may need to drain the pus from them.

Stenosis of the ear canal

Stenosis is the name given to the build-up of thick, dry skin in your ear canal, which can occur if you have the condition chronic otitis externa.

It can affect your hearing because the build-up of skin makes your ear canal narrower. In rare cases, it can cause deafness. Stenosis of the ear canal can be treated using eardrops.

Inflamed or perforated eardrum

It is possible for any infection to spread to your eardrum.

In some cases, the infection may cause pus to build up inside your inner ear and may rupture (tear) your eardrum. This is know as a perforated eardrum.

Symptoms include:

  • temporary hearing loss
  • earache or discomfort
  • a discharge of mucus from your ear
  • ringing or buzzing in your ear (tinnitus)

In many cases a perforated eardrum will heal without treatment in around two months. If it shows no signs of healing after this time then surgery may be recommended.


Cellulitis is a bacterial skin infection that can occur after otitis externa. It's when bacteria, which normally live harmlessly on the surface of your skin, enter your skin's deeper layers through damaged areas, such as those caused by otitis externa.

Cellulitis causes affected areas of skin to become red, painful, hot and tender to the touch.

Other symptoms include:

  • feeling sick
  • shivering
  • chills
  • a general sense of feeling unwell

Most cases of cellulitis can be treated with a seven-day course of antibiotics.

If cellulitis occurs in a person who was already very ill or who is very vulnerable to the effects of infection, they may need to be admitted to hospital as a precaution.

Malignant otitis externa

Malignant otitis externa is a serious but very rare complication of otitis externa, in which the infection spreads to the bone that surrounds your ear canal.

Malignant otitis externa usually affects adults more than children. In particular, adults who are immunocompromised (have a weakened immune system) have an increased risk of developing it. This includes people having chemotherapy treatment or who have a chronic (long-term) health condition, such as diabetes, HIV or AIDS.

If you have malignant otitis externa, you may have one or more of the following symptoms:

  • severe ear pain and headaches
  • exposed bone visible in your ear canal
  • facial nerve palsy, where your face droops on the side of the affected ear

Without treatment, malignant otitis externa can be fatal. However, it can be effectively treated using antibiotics and surgery to remove any damaged tissue.

Medical Review: March 29, 2012
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