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1. Laboratory testing
2. Imaging studies
3. Most persons with OE are treated empirically. Primary treatment involves the following:
4. Pharmacotherapy
5. Surgery

High-resolution computed tomography (CT) - Preferred; better depicts bony erosion

Antifungal agents (eg, otic clotrimazole 1% solution, nystatin powder)

Removal of debris from the EAC

Radionucleotide bone scanning

Incision and drainage of an abscess

Blood glucose level

Surgical debridement of the ear canal - Usually reserved for necrotizing OE or for complications of OE (eg, external canal stenosis); often necessary in more severe cases of OE or in cases where a significant amount of discharge is present in the ear; mainstay of treatment for fungal infections

Gallium scanning

Avoidance of contributing factors

Urine dipstick

Administration of topical medications to control edema and infection

Gram stain and culture of any discharge from the auditory canal

Topical medications (eg, acetic acid in aluminum acetate, hydrocortisone and acetic acid otic solution, alcohol vinegar otic mix)

Pain management

Magnetic resonance imaging (MRI) - Not used as often as the other modalities; may be considered secondarily or if soft-tissue extension is the predominant concern

Antibiotics (eg, hydrocortisone/neomycin/polymyxin B, otic ofloxacin, otic ciprofloxacin, otic finafloxacin, gentamicin 0.3%/prednisolone 1% ophthalmic, dexamethasone/tobramycin, otic ciprofloxacin and dexamethasone, otic ciprofloxacin and hydrocortisone suspension)

Oral antibiotics (eg, ciprofloxacin)

Analgesic agents (eg, acetaminophen, acetaminophen and codeine)