Symptoms for all forms of otitis externa include pain, itching, and swelling of the ear canal. Symptoms of chronic, recurrent otitis externa include lack of earwax and buildup of dead skin causing narrowing of the ear canal. Symptoms of malignant necrotizing otitis externa include severe ear pain, facial paralysis, difficulty opening mouth, and difficulty swallowing. History of allergies, aquatic-based occupations, or exposure to sources of immunocompromise such as chemotherapy and diabetes mellitus should be considered in otitis externa patients.

A carefully collected history from a patient with otitis externa may include:

• History of allergies manifesting as [dermatitis]]^[1]
• History of an occupation involving swimming, scuba-diving, or surfing
• History of immunosuppression in cases of malignant otitis externa:
  • Recent chemotherapy
  • History of diabetes mellitus

Symptoms of acute otitis externa include:^[2]

• Ear pain
• Itching of the ear canal
• Swelling of the ear canal
• Redness of the ear canal
• Pressure inside the ear
• Discharge
• Pain in the jaw when in motion
• Partial hearing loss
• Swollen lymph nodes
• Scaley skin in the ear canal

Symptoms of chronic, recurrent otitis externa include:^[3]

• Persistent itching of the ear
• Lack of earwax
• Buildup of dead skin causing narrowing of the ear canal

Symptoms of malignant necrotizing otitis externa include:^[4][5]

• Severe ear pain
• Facial paralysis
• Difficulty opening mouth
• Difficulty swallowing