Running Head: SOAP NOTE 1
Subjective Analysis
Otitis externa refers to inflammation of the external auditory canal. Infections, allergies
and dermatologic disorders are known to be the causative factors. The first s
...
Running Head: SOAP NOTE 1
Subjective Analysis
Otitis externa refers to inflammation of the external auditory canal. Infections, allergies
and dermatologic disorders are known to be the causative factors. The first step in the
pathogenesis of the external otitis is the breakdown of the skin-cerumen layer which leads to
inflammation and edema, thereby causing pruritus and obstruction. The pruritus leads to
scratching which precipitates further injury. This sequel of events changes the amount of
cerumen production, impairs the migration of epithelial tissue and increases the ph inside the ear
canal. As a result, this creates a dark, alkaline, moist environment which then becomes the
breeding ground for organisms (Gogugen, 2019).
Some of the risk factors include water exposure which creates a moist, soft environment
which then causes the breakdown of the skin-cerumen barrier, thereby changing the microflora
of the ear canal. Some additional risk factors include trauma secondary to excess cleaning or
SOAP NOTE 2
scratching which also removes cerumen and creates abrasions on the inner ear lining.
Dermatologic disorders such as psoriasis, atopic/contact/allergic dermatitis can also predispose to
external otitis (Gogugen, 2019).
G.T. reported ear pain, difficulty hearing, fever and denied any discharge. Some of the
other questions to ask during assessment include: previous history of ear infections, skin
conditions, previous ear surgery or radiation, water exposure, use of foreign devices in the ear
and of any know tympanic membrane perforation (Gogugen, 2019). Upon reflection, I should
have asked G.T. about any chronic skin conditions and prior radiation therapy as it would have
helped me with the differentials
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