Otitis Externa prevention

[Duke Dive Medicine]

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.

Hi Judy,

Navy saturation divers use otic Domeboro's solution as prophylaxis against otitis externa. You might ask your provider for a prescription (if it's available - it can be hard to find). You could also try a mixture of 50/50 white vinegar and isopropyl alcohol (More On Swimmers Ear — DAN | Divers Alert Network — Medical Dive Article), letting it dwell in the ear canal for a few minutes after each dive. Also would echo the advice to rinse your ears out with fresh water after every dive, just as you'd rinse your equipment (do the fresh water rinse before you instill the ear solution). A hood can help keep debris out but will not exclude microorganisms. I don't have any experience with devices like Doc's Pro Plugs but there's a lengthy thread linked above.

Best regards,
DDM

 

[Lorenzoid]

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.

Sorry--to clarify, when I said "vinegar solution" I was referring to the common vinegar-alcohol solution. I tried to keep the reply simple rather than getting into specific ratios of vinegar, alcohol, or other things--hydrogen peroxide, glycerin, etc.--that some people say they also include in their mixture. There are enough threads on "ear beer."

 

[Eyegore]

I've been struggling with otitis externa since December and this morning hearing in the affected ear is compromised and there is discharge for the first time. I'm now instilling antibiotic drops 2X/day and a mild steroid to subdue pruritus. Opinions on the best way to prevent this from happening again?

 

[Seaweed Doc]

I've been struggling with otitis externa since December and this morning hearing in the affected ear is compromised and there is discharge for the first time. I'm now instilling antibiotic drops 2X/day and a mild steroid to subdue pruritus. Opinions on the best way to prevent this from happening again?

I swim regularly as well as dive, and if I'm religiously devoted to putting in a 50:50 mix of white vinegar and alcohol it seems to prevent it. In fact, if I'm 100% consistent, alcohol alone does it.

Edit: Well, I SWAM regularly until the pools were closed by the governor.

 

[Eyegore]

Excellent--thanks, I will try it!

 

[Ukmc]

2% acetic acid soln is plenty to keep most bacterial as well as fungal pathogens away. (Available as pharmaceutical preparation or can be achieved by mixing distilled white vinegar in equal parts with Propyl alcohol and water) You can use it after each dive and as needed. 2 drops of mineral oil once or twice a week will keep ear wax accumulation at bay for most of the people. Atopic itchy ears is a different problem.