Otitis externa


En estos días de verano, quizás hayas escuchado hablar del “oído del nadador” o también llamada otitis externa. Hoy te explicamos algunos aspectos sobre ella.

¿Qué es la otitis externa?
También se le denomina “oído del nadador”, aunque no sólo afecta a nadadores. Es una infección del conducto auditivo externo, la parte del oído que conecta la oreja con el tímpano. Son más frecuentes en niños y en los meses de verano, en relación a piscinas.

¿Cuáles son sus causas?
Se produce cuando la piel del conducto se irrita o se daña y luego se infecta por bacterias u hongos. Esto puede ocurrir cuando:

  • Se introducen bastoncillos, el dedo u otros objetos en el oído.
  • Se limpia el oído para quitar la cera.
  • Se nada habitualmente (el agua puede reblandecer la piel del canal auditivo, lo que facilita que los gérmenes produzcan la infección).
  • Se utilizan audífonos, cascos o tapones que puedan dañar la piel del oído.
  • Se padece alguna enfermedad de la piel que favorece la infección (eccemas, psoriasis…)

¿Qué síntomas produce?

  • Dolor intenso, sobre todo al movilizar la oreja.
  • Picor.
  • Supuración.
  • Disminución de la audición.

No suele producir fiebre ni es contagioso. Si se tiene alguno de estos síntomas hay que consultar con un médico.
¿Cómo se diagnostica?
El diagnóstico es sencillo. El médico preguntará por los síntomas y realizará una inspección con el otoscopio. En alguna ocasión se puede tomar una muestra para cultivo de las secreciones.
¿Cuál es el tratamiento?

  • Gotas óticas: su función es reducir el dolor e inflamación producidos por la otitis y tratar la infección. Es importante aplicarlas correctamente para que lleguen al conducto. Se recomienda inclinar la cabeza para asegurarse de que entran y mantenerse con la cabeza así unos 10 minutos. En este enlace, podéis encontrar un vídeo explicativo de cómo aplicarlas. Es importante acabar el tratamiento los días que haya recomendado el médico (aproximadamente unos 7-10 días) aunque se haya mejorado y no se tengan síntomas.
  • Analgésicos.
  • En algunas ocasiones hay que aspirar las secreciones para permitir la entrada de las gotas y mejorar los síntomas. En algún caso grave será preciso tomar un antibiótico vía oral.

Se comienza a notar mejoría a las 36-48 horas de haber empezado el tratamiento. Si el dolor empeora o no mejora transcurrido este tiempo, consulta con tu médico.
¿Debo hacer algo más durante el tratamiento?
Es importante mantener el oído seco mientras se cura la infección. Hay que evitar sumergirse en agua durante 7-10 días tras el inicio del tratamiento, pero sí se puede duchar con precaución de que no entre agua. Se puede utilizar un trozo de algodón impregnado en vaselina en el exterior del oído cubriendo la entrada SIN introducirlo en el conducto.
También hay que evitar introducir objetos como cascos o audífonos hasta que la infección mejore.
¿Cómo se puede prevenir?

  • No introducir objetos en el oído ni limpiarlo con bastoncillos. No se debe limpiar el interior de los oídos, es normal tener cera dentro del oído, ya que protege el tímpano. Si hay mucha cera o se produce un tapón lo mejor es consultar con su médico o enfermera para extraer la cera.
  • Los nadadores: secar bien los oídos después del baño y utilizar tapones para prevenir la entrada de agua en el oído. Mantener los tapones limpios y cambiarlos si están muy sucios o deteriorados.

Más información:  www.cdc.gov/healthywater/swimming/audience-espanol.html


Noemí Rodríguez Panedas

Médico residente, MFyC, C.S. Parquesol, Valladolid.

REFERENCIAS:

  • Uptodate
  • http://www.fisterra.com/m/ficha.asp?idTipoFicha=1&urlseo=otitis-externa
  • Gil-Carcedo L.M., Vallejo Valdezate L.A. Otitis Externa Bacteriana. En: Ergon Editores. El oido externo. Ergon; 2001. p. 341-365
  • Morera Perez, C. Marco Algarra, J. Patología del Oído Externo. En: Glosa S. L. Editores. Lecciones de Otorrinolaringología Aplicada, Tomo II. Editorial Glos; 2004. p. 61-64ç
  • Jafek B W, Murrow B W. Enfermedades del Oído Externo y del Tímpano. En: Elsevier España Editores. Otorrinolaringología Secretos. Elsevier Editores; 2006. p. 73-77

Revisado: julio 2017

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