Otitis Externa prevention

[judyo1]

I've been struggling with recurrent otitis externa post tropical diving and am after any suggestions for prevention.
I used to get otitis externa prior to diving / when I wasn't diving so guess I am a little prone to it.
I am a bit atopic and often have 'itchy' ears when my hayfever is bad.

i use vosol ear drops (acetic acid & propolyne glycol) daily when diving. On the last trip I did they were really starting to irritate my ears and hurt so I stopped.
I also have ear drops that are almond oil with 1% hydrocortisone (helps with the itchy ears when not diving).

I take sofradex ear drops with me diving and start using them if ear starting to get sore.

My last 2 episodes of otitis externa have been pseudamonas. Responded to cipro drops, ear microsuction (and one episode also required oral cipro and prednisone). Previously I've had fungal otitis externa. (gross). I wouldn't wish otitis externa on my worst enemy but am after any other ideas for prevention. (my GP didn't have any further ideas).

I have ordered a Mack's ear dryer off Amazon..

Any other suggestions would be gratefully appreciated.

 

[chillyinCanada]

You don't ever use q-tips in your ears, do you?

 

[judyo1]

You don't ever use q-tips in your ears, do you?

absolutely not! Nothing smaller than my elbow goes in my ears.....

 

[Mod63]

Besides the usual
- don't muck around to much with your ears, it will usually be for the worse than for the better
- rinse ears after diving with clean fresh water
- keep tem warm and out of the wind
I do wear a thin hood like the one from Lavacore Lavacore Hood — Lavacore International
Did not have issues ever since

 

[chillyinCanada]

absolutely not! Nothing smaller than my elbow goes in my ears.....

Just thought I'd best double check since you said they get itchy.

 

[Oitzu]

I can only say what helped me with this problem:
- Wearing hood or ear plugs during dive https://www.scubaboard.com/communit...a-mini-review-of-the-2-different-types.582741
- Flushing ears with clean water after dive
- Drops with isopropanol, acetic acid and dexpanthenol

 

[jgttrey]

I heard somewhere that the Navy diver formula was Isopropyl alcohol, vinegar and a little glycerin and the protocol was five minutes in each ear before diving and then again afterwards. The idea being that the acetic acid in the vinegar kills or reduces the bacteria, the alcohol displaces the water and the glycerin moisturizes the skin, keeping it from cracking and providing entry for bacteria.

Anyway, I read that somewhere and mixed up a batch. A few bucks will get you nearly a lifetime supply.

Other than smelling like salad dressing for few minutes, it seems to do the job. However, I haven't had a big problem with swimmers ear anyway, so I can't really give you a report on effectiveness for anything beyond getting the water out, which it seems to do as well as Macks.

 

[doctormike]

I've been struggling with recurrent otitis externa post tropical diving and am after any suggestions for prevention.
I used to get otitis externa prior to diving / when I wasn't diving so guess I am a little prone to it.
I am a bit atopic and often have 'itchy' ears when my hayfever is bad.

i use vosol ear drops (acetic acid & propolyne glycol) daily when diving. On the last trip I did they were really starting to irritate my ears and hurt so I stopped.
I also have ear drops that are almond oil with 1% hydrocortisone (helps with the itchy ears when not diving).

I take sofradex ear drops with me diving and start using them if ear starting to get sore.

My last 2 episodes of otitis externa have been pseudamonas. Responded to cipro drops, ear microsuction (and one episode also required oral cipro and prednisone). Previously I've had fungal otitis externa. (gross). I wouldn't wish otitis externa on my worst enemy but am after any other ideas for prevention. (my GP didn't have any further ideas).

I have ordered a Mack's ear dryer off Amazon..

Any other suggestions would be gratefully appreciated.

Yup, OE can be excruciating. I have had patients say that it's up in the childbirth and kidney stone range.

The Ear Dryer is great, I recommend them all the time and sell them in my office.

Another thing that helps prevent the problem is Ear Shield.

If you have a lot of impacted wax, have that cleaned out by your ENT doc with a microscope and curette or suction, often necessary to get it all out. The wax retains moisture and makes it very hard to treat OE once it has happened.

The bug is almost always pseudomonas. That actually lives in normal ear canals, but it takes hold when the ear canal skin breaks down and the protective coating is washed away by excessive water exposure (and we all love excessive water exposure!).

The best way to make that ear drop mix (if you have an early OE and can't get Cortisporin Otic or something like that) is to take a bottle of rubbing alcohol, add a few tablespoons of white vinegar (remember, it should be mostly alcohol, with just enough vinegar to drop the pH), and maybe a little glycerin if you can get some. Rinse your ear canal with that twice a day and use the ear dryer.

Fungal OE ("jungle ear") is often a complication of overuse of antibiotic drops. Treatment is cleaning, dry ear and some antifungal agent (I use boric acid powder).

Careful about using unventilated ear plugs when diving. Some people use this mask to protect their ears but to avoid barotrauma.

 

[Lorenzoid]

I hope the ear dryer helps. As I guess you know, for most people a simple vinegar solution (acetic acid) is sufficient to stave off pseudomonas.

 

[doctormike]

I hope the ear dryer helps. As I guess you know, for most people a simple vinegar solution (acetic acid) is sufficient to stave off pseudomonas.

Actually, the point is to keep the ear dry. So if you use vinegar, which is mostly water, you will be keeping the ear wet.

The point of using alcohol is that it evaporates and has less water in it (depending on concentration), and you only need a small amount of vinegar in it to drop the pH way below the point that the pseudomonas is killed.