Summary
Otitis externa (OE) is inflammation of external-canal skin, causing pain, itch, discharge and swelling. UK consensus defines acute diffuse OE as lasting under 6 weeks; persistent disease is reassessed for chronic inflammation and an underlying cause before further topical treatment.
Aural toilet and correctly delivered topical therapy treat uncomplicated disease; oral antibiotics are not routinely used as they have poor efficacy when used alone. Confirm drum integrity before choosing drops. ENT UK2023
Severe persistent/night pain, granulation, exposed bone or cranial neuropathy consider CT temporal bones (contrast MRI for cranial-nerve involvement) and biopsy of granulation to exclude necrotising otitis externa (NOE) or another destructive lesion.