Audiology-Driven Strategies to Prevent Otitis Externa in Clinical Settings

Otitis externa, often called “swimmer’s ear”, is a common, preventable condition that can cause significant discomfort, hearing loss, and even serious complications if left untreated. As the demand for advanced hearing care increases, audiology clinics are well-positioned to lead the way in preventing otitis externa through early detection, patient education, and evidence-based protocols. By integrating audiology services into prevention strategies, clinical teams can reduce the incidence of this condition and improve patient outcomes across all age groups. 

The Role of Audiology Clinics in Early Prevention Protocols

Audiology clinics are uniquely positioned to initiate early prevention protocols for otitis externa due to their specialised focus on ear health and hearing. Routine audiology evaluations can identify patients at higher risk, such as those with narrow ear canals, excessive earwax, or dermatological conditions affecting the ear. During a standard audiology test, clinicians can assess the integrity of the external auditory canal and offer personalised advice on ear hygiene and moisture control.

Clinics can implement the following measures:

• Routine otoscopy and audiology evaluation to detect early otitis externa symptoms such as canal redness, itching, or mild discomfort.
• Patient education on what aggravates otitis externa, including appropriate ear cleaning techniques, use of earbuds, and moisture avoidance.
• Proactive management of cerumen, reducing the risk of blockage and infection, and recommending appropriate ear solutions for otitis externa prevention.

These strategies, when integrated into the standard of care at the audiology centre, can significantly reduce the risk of initial and recurrent otitis externa.

Pediatric Considerations: Tailoring Preventive Audiology Services

Children are more prone to infections due to narrower ear canals, more frequent water exposure during play or swimming, and less developed ear hygiene habits. Audiology pediatric services are essential for tailoring preventive strategies that consider the unique anatomical and behavioural factors in this population.

Pediatric-focused prevention includes:

• Regular screenings: Early audiology tests and otoscopy can identify at-risk children before symptoms escalate.
• Parental education: Audiologists should teach parents about the avoidance of otitis externa triggers, such as cotton swabs and water retention in the ear canal.
• Custom ear protection: For children who swim frequently, audiology centres can provide custom-fitted swim moulds, reducing moisture exposure without the irritation caused by generic earplugs.
• Behavioural guidance: Teaching children not to scratch or insert objects into their ears is a key preventive measure.

Engaging both the child and caregiver in education leads to better long-term outcomes.

Integrating Audiology Evaluations into Otitis Externa Risk Management

Routine audiology evaluations can be a cornerstone of effective risk management for otitis externa, and audiology clinics and centres should integrate several key elements into their protocols. 

Establishing baselines and follow-up audiology tests is essential, as it helps distinguish otitis externa symptoms from other causes of hearing loss and ensures the prompt detection of any complications. By aligning audiology services with dermatology and ear-nose-throat (ENT) protocols, clinics can identify patients with high-risk behaviours or comorbidities, initiate preventive interventions such as recommending hypoallergenic hearing aids or cerumenolytic agents in case of earwax buildup, and provide clear guidance on otitis externa self-care. 

Audiologists are also trained to perform differential diagnoses, recognising when symptoms might be mistaken for otitis externa but are actually due to other issues, such as middle ear disease or chronic otitis media. Throughout treatment, audiology clinics play a vital role in monitoring patient progress, ensuring that interventions for acute otitis externa are effective and that any red flags, such as persistent pain, swelling, or hearing loss, are addressed promptly.

Professional Guidelines for Audiologists in Otitis Externa Prevention

Professional guidelines underscore the importance of a multidisciplinary approach to otitis externa prevention, with audiologists playing a pivotal role. Best practices involve avoiding unnecessary manipulation or cleaning of the ear canal, as this can disrupt the natural protective barrier and increase the risk of infection. The preventive use of acidifying or astringent ear drops to decrease the risk of otitis externa after water exposure is also recommended, particularly for high-risk individuals. It is also essential to educate patients about the signs and symptoms of otitis externa, such as pain, itching, swelling, or discharge, and to advise them on when to seek medical attention. Audiologists should be vigilant for “red flags”, including severe pain, granulation tissue, or symptoms extending beyond the ear canal, as these may indicate more serious conditions requiring urgent referral. 

Ultimately, guidance on otitis externa self-care and the appropriate use of prevention products as part of a broader treatment plan is crucial. By adhering to these guidelines, audiologists ensure that preventive measures are evidence-based, patient-centred, and seamlessly integrated into clinical workflows.

The question What is the prevention for otitis externa? doesn’t have a one-size-fits-all answer. It requires targeted, context-specific strategies, and audiology services are a key part of that answer. By promoting proactive care, offering tailored evaluations, and implementing best practices, audiologists can have a significant impact on public ear health.

At Mitelos, we support this mission by developing well-tolerated, evidence-based ear care solutions designed to complement the work of audiologists and ENT professionals. If you’re looking for a partner to enhance your clinical protocols or develop custom solutions for otitis externa prevention, contact us!

References

Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA, Huang WW, Haskell HW, Robertson PJ. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. 2014 Feb;150(1 Suppl):S1-S24. doi: 10.1177/0194599813517083. Erratum in: Otolaryngol Head Neck Surg. 2014 Mar;150(3):504. Erratum in: Otolaryngol Head Neck Surg. 2014 Mar;150(3):504. doi: 10.1177/0194599813517083 

NHS inform. Otitis externa [Internet]. 2024 May 2 [cited 2025 Jun 10]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/otitis-externa/ 

Interorganizational Group for Speech-Language Pathology and Audiology. Infection Prevention and Control Guidelines for Audiology [Internet]. Canada: Canadian Interorganizational Group for Speech-Language Pathology and Audiology; 2010 Mar [cited 2025 Jun 16]. Available from: https://canadianaudiology.ca/wp-content/uploads/2016/11/Infection-Prevention-and-Control-Guidelines-for-Audiology.pdf