Otitis externa — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 25 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting otitis externa or death from otitis externa with the circumstances of a person's relevant service:

1. (1)
   participating in aquatic activities within the ten days before the clinical onset of otitis externa;

   Note: aquatic activities is defined in the Schedule 1 - Dictionary.

2. (2)
   being exposed to hot and humid weather conditions or heavy rains, on at least ten days within the 30 days before the clinical onset of otitis externa;

   Note: hot and humid weather conditions is defined in the Schedule 1 - Dictionary.

3. (3)
   undergoing a course of therapeutic radiation for cancer, where the affected ear was in the field of radiation, before the clinical onset of otitis externa;
4. (4)
   having trauma to the external auditory canal of the affected ear within the ten days before the clinical onset of otitis externa;

   Note: Examples of trauma include a blunt or penetrating injury, a surgical procedure and blast force.

5. (5)
   having a foreign object or implement inserted into, or removed from, the external ear canal of the affected ear within the ten days before the clinical onset of otitis externa;

   Note: An example of a foreign body or implement is an ear lavage instrument used for aural irrigation.

6. (6)
   blocking the external auditory canal of the affected ear with an extrinsic aural device for a cumulative period of at least eight hours within the seven days before the clinical onset of otitis externa;

   Note: extrinsic aural device is defined in the Schedule 1 - Dictionary.

7. (7)
   having an acquired, persistent narrowing or obstruction of the external auditory canal of the affected ear at the time of the clinical onset of otitis externa; (a) benign or malignant neoplasm; (b) cerumen accumulation; (c) exostosis of the external auditory canal; and (d) granuloma;

   Note: Examples of causes of narrowing or obstruction of the external auditory canal include:.

   Note: exostosis of the external auditory canal is defined in the Schedule 1 - Dictionary.

8. (8)
   having an inflammatory skin disease at the time of the clinical onset of otitis externa, where the skin disease involves the external auditory canal of the affected ear;

   Note: Examples of an inflammatory skin disease include allergic or irritant contact dermatitis, seborrhoeic dermatitis, lichen planus, psoriasis and eczema.

   Note: Irritant or allergic contact dermatitis of the external auditory canal may be caused by shampoos, ototopical medications or accidental chemical splashes to the ear.

9. (9)
   having an infectious, autoimmune or granulomatous disease at the time of the clinical onset of otitis externa, where the disease involves the external auditory canal of the affected ear;

   Note: Examples of an infectious, autoimmune or granulomatous disease include herpes zoster, relapsing polychondritis and sarcoidosis.

10. (10)
    having chronic suppurative otitis media, involving the middle ear of the affected side, within the 30 days before the clinical onset of otitis externa;

    Note: chronic suppurative otitis media is defined in the Schedule 1 - Dictionary.

11. (11)
    having diabetes mellitus at the time of the clinical onset of otitis externa;
12. (12)
    being in an immunocompromised state as specified at the time of the clinical onset of otitis externa;

    Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

13. (13)
    for otomycosis only, taking a course of oral antibiotic therapy or having ototopical therapy for the treatment of otitis externa of the affected ear within the 30 days before the clinical onset of otitis externa;

    Note: otomycosis is defined in the Schedule 1 - Dictionary.

14. (14)
    participating in aquatic activities within the ten days before the clinical worsening of otitis externa;

    Note: aquatic activities is defined in the Schedule 1 - Dictionary.

15. (15)
    being exposed to hot and humid weather conditions or heavy rains, on at least ten days within the 30 days before the clinical worsening of otitis externa;

    Note: hot and humid weather conditions is defined in the Schedule 1 - Dictionary.

16. (16)
    undergoing a course of therapeutic radiation for cancer, where the affected ear was in the field of radiation, before the clinical worsening of otitis externa;
17. (17)
    having trauma to the external auditory canal of the affected ear within the ten days before the clinical worsening of otitis externa;

    Note: Examples of trauma include a blunt or penetrating injury, a surgical procedure and blast force.

18. (18)
    having a foreign object or implement inserted into, or removed from, the external ear canal of the affected ear within the ten days before the clinical worsening of otitis externa;

    Note: An example of a foreign body or implement is an ear lavage instrument used for aural irrigation.

19. (19)
    blocking the external auditory canal of the affected ear with an extrinsic aural device for a cumulative period of at least eight hours within the seven days before the clinical worsening of otitis externa;

    Note: extrinsic aural device is defined in the Schedule 1 - Dictionary.

20. (20)
    having an acquired, persistent narrowing or obstruction of the external auditory canal of the affected ear at the time of the clinical worsening of otitis externa; (a) benign or malignant neoplasm; (b) cerumen accumulation; (c) exostosis of the external auditory canal; and (d) granuloma;

    Note: Examples of causes of narrowing or obstruction of the external auditory canal include:.

    Note: exostosis of the external auditory canal is defined in the Schedule 1 - Dictionary.

21. (21)
    having an inflammatory skin disease at the time of the clinical worsening of otitis externa, where the skin disease involves the external auditory canal of the affected ear;

    Note: Examples of an inflammatory skin disease include allergic or irritant contact dermatitis, seborrhoeic dermatitis, lichen planus, psoriasis and eczema.

    Note: Irritant or allergic contact dermatitis of the external auditory canal may be caused by shampoos, ototopical medications or accidental chemical splashes to the ear.

22. (22)
    having an infectious, autoimmune or granulomatous disease at the time of the clinical worsening of otitis externa, where the disease involves the external auditory canal of the affected ear;

    Note: Examples of an infectious, autoimmune or granulomatous disease include herpes zoster, relapsing polychondritis and sarcoidosis.

23. (23)
    having chronic suppurative otitis media, involving the middle ear of the affected side, within the 30 days before the clinical worsening of otitis externa;

    Note: chronic suppurative otitis media is defined in the Schedule 1 - Dictionary.

24. (24)
    having diabetes mellitus at the time of the clinical worsening of otitis externa;
25. (25)
    being in an immunocompromised state as specified at the time of the clinical worsening of otitis externa;

    Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

26. (26)
    for otomycosis only, taking a course of oral antibiotic therapy or having ototopical therapy for the treatment of otitis externa of the affected ear within the 30 days before the clinical worsening of otitis externa;

    Note: otomycosis is defined in the Schedule 1 - Dictionary.

27. (27)
    inability to obtain appropriate clinical management for otitis externa;

Aggravation-only factors: the factors in subsections 9(14) to 9(27) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.