The normal ear is "designed" so that water can enter and exit without causing any problem. However, there are cases in which this does not happen and water that enters causes otitis. In these cases, the beach and pool baths, common during the bathing season, can be a problem. How the ear is made The ear is divided into three parts: outer ear, middle ear, and inner ear. The external ear is formed by the ear and the external auditory canal, which ends at the eardrum; The middle ear is made up of the eardrum membrane and the cavity behind it, where the ear ossicles are contained; The inner ear is responsible for auditory perception and balance. Otitis externa Otitis externa is the most common cause of ear pain during the bathing season. It is an infection of the skin and subcutaneous tissue of the external ear canal and causes: Ear pain, or otalgia, which can be very severe; Exit of purulent secretion through the ear canal (otorrhea); Sensation of blocked ear due to obstruction of the ear canal; Itching. Otitis externa rarely develops with fever. What increases the possibility of external otitis Water entering the ears, which causes skin maceration and removal of the protective skin wax. Paradoxically, if there is excess wax, there is water retention in the ear canal and maceration; Skin lesions of the ear canal (caused by scratching the ears and using cotton swabs); Chronic eczema of the ear canal; Exostoses, commonly called a diver or surfer ear, with a narrowing of the ear canal that makes it difficult to aerate and get water out of the ear. All these factors lead to an increase in the humidity of the ear canal , with a change in the pH of the skin and favor the growth of bacteria that cause otitis externa. What to do to prevent otitis externa during the bathing season In patients who have an excessive production of earwax, it is recommended to clear the ear canal before the bathing season; In patients with chronic ear canal eczema, it is recommended to treat it and use earplugs to prevent water from entering the ear canal;In patients who have recurrent external otitis it is recommended to use drops that promote the evaporation of water from the ear canal after baths or the use of tampons; The use of cotton swabs is always contraindicated. Otitis media Otitis media is an infection of the middle ear, which occurs following a high respiratory infection. It can develop with intense otalgia, fever, otorrhea and perforation of the eardrum membrane. It is essential in these cases to prevent water from entering the ears as an integral part of treating the infection, which also includes the use of antibiotics. In chronic otitis media, with chronic perforation of the eardrum membrane, water must always be prevented from entering the ear, with the risk of worsening the infection. Treatment The treatment of otitis should be determined in an Otorhinolaryngology consultation . In this consultation, diagnostic evaluation, cleaning of the ear canal and treatment institution are carried out. This treatment may include topical and anti-inflammatory antibiotics or, in more severe cases, topical and systemic antibiotics, systemic corticosteroids and analgesics. In patients with a tendency to develop ear infections after exposure to water, an evaluation in an Otorhinolaryngology consultation is also very important for guidance on prevention measures. References Figueiredo RR, Fabri Ml, Machado WS. Otite externa difusa aguda: um estudo prospectivo no verão do Rio de Janeiro. Rev Bras Otorrinolaringol 2004;70(2):226-31. Author : Rosário Figueirinhas Meet the Otorhinolaryngology team of Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
