Chart 1 – (Appendix – to be inserted here)

Discussion

Chronic otitis externa (COE) is a common otological problem encountered regularly by clinicians in primary and secondary care with lifetime incidence reported to be up to 10%. (2,6) Otolaryngologists in secondary care often receive referrals of challenging cases of COE, where most conventional treatments have been exhausted and failed. (2,6) Although there have been few randomised controlled trial involving chronic cases along with acute otitis externa, no single recommendations can be derived for the treatment of COE as a separate clinical disorder. (1,9)