2- External ear Flashcards
How do patients present with cerumen impaction
hearing loss ear ache reflex cough (CN X) dizziness tinitus itchiness
How do you treat cerumen impaction
detergent ear drops
mechanical removal
body temperature water (dry after irrigation)
When should you NOT irrigate
when the TM is not intact
What side are FB mostly
R sided (because of being right handed)
What may symptoms of a FB be
usually asymptomatic but can be decreased hearing, pain, drainage, chronic cough, hiccups
What FB are the most dangerous
button batteries, insects, and penetrating FB- urgent removal!
What is otitis externa
inflammation of the EAC
aka “swimmer’s ear”
What are RF for otitis externa
warm humid climate water exposure trauma occlusive device term debris (eczema)
What can otitis externa lead to
periauricular cellulitis
contact dermatitis
malignant otitis externa
What causes otitis externa
Bacteria (gram - pseudomonas)
allergic
dermatologic
fungal (aspergillus, candida)
What is the clinical presentation of otitis externa
foul smelling/purulent dx, ear canal granulation, CN palsies, HA, otalgia, pruritus,
What will a CT of malignant otitis externa show
osseous erosion
What will you see on otitis externa PE
erythema/edema, purulent exudate, tenderness with triages pressure, canal edema w/ possible TM obstruction
What will the TM do in otitis EXTERNA
TM will be mobile with pneumatic otoscopy
How do you treat otitis externa
7-10 days Topical Aminoglycoside/fluoroquinone
+/- corticosteroids
How do you treat malignant otitis externa
IV Quinolone/surgery
How should you support medical treatment of otitis externa
Keep canal dry
Keep canal open with a wick
NO drops if TM is perforated
What patient education is important with otitis externa
avoid water accumulation wear ear plugs when swimming hair dryer to dry ear canal Acidifying drops into ear canal stop removing wax!
What is Ramsay Hunt Syndrome
HSV causes vesicles on outer ear and facial paralysis
What is a hematoma of the external ear
traumatic auricular hematoma that can develop into cauliflower ear if not drained ASAP
