ABC of ENT. Pain in the ear.

Acute otitis externa may be a diffuse inflammation or a furuncle. A furuncle is a very tender swelling in the outer ear canal (there are no hair follicles in the bony meatus). Hearing is impaired only if the meatus is blocked by swelling or discharge, and fever occurs only when infection spreads in front of the ear, as cellulitis or erysipelas. Tender enlarged nodes may be palpable in front or behind the ear, but the tenderness is superficial, unlike the tenderness on deep pressure in acute otitis media. The pinna is tender on movement, which, again, does not occur in acute otitis media. Any discharge is thick and scanty, unlike the copious mucoid discharge of middle ear infection.