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Sydney Child Health Program > 37.2 Outer and Middle Ear Conditions > Flashcards

37.2 Outer and Middle Ear Conditions Flashcards

1
Q

ddx for conductive hearing loss?

A 
wax
exostoses
foreign body
atresia
stenosis
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2
Q

otitis externa caused by 2 main things?

A

bacteria: pseudomonas/staph aureus

fungal

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3
Q

presentation of otitis externa?

A

smelly
painful to move the pinna
-discharge

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4
Q

management of otitis externa?

A
  • swab MCS
  • stay on side for 5-10 minutes
  • sofradex
  • keep it dry
  • topical drops
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5
Q

otitis externa fungal? presentation?

A
  • candida, aspergillosis
  • can see black dots.spores
  • not painful
  • itchy
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6
Q

drops for fungal otitis externa?

A 
if drum intact:
locacortin-viofrom drops
-kenacomb drops
-nilstat drops
-Need Rx for 3 weeks
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7
Q

management of ear wax?

A

nothing if no problem

  • ceruminolytics
  • syringing: no if perforation or if only hearing ear
  • aural toilet
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8
Q

foreign body in ear: bug?

A

drown it in olive oil

direct/syringe

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9
Q

foreign body in ear: bead?

A
  • suction
  • glue in stick
  • wax curette
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10
Q

glue ear definition?

A

CHRONIC Otitis media with effusion:

>3months or more

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11
Q

risk factors for chronic Otitis media with effusion?

A 
season: fall-winter
FHx
-URTI
-cleft palate
-child care centres
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12
Q

likely cause of chronic Otitis media with effusion?

A

biofilm

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13
Q

how to find out if fluid in middle ear?

A

pneumatic otoscopy

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14
Q

which retraction pockets are dangerous?

A

posterior: damage to ossicles through erosion from vibration - like sand paper
- Manage with grommets

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15
Q

what to remember with kids with resolved chronic Otitis media with effusion?

A

check in a few months for any retraction pockets

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16
Q

how old to use the otovent?

A

age 6 usually

17
Q

how does otovent work?

A

positive pressure in post nasal space, pushes air up the eustachian tube

18
Q

steroids for chronic Otitis media with effusion?

A

NOPE

19
Q

grommets, any discharge through them?

A

no, should allow drainage into eustachian tube

20
Q

chronic Otitis media with effusion and adenoidectomy?

A

research divided

-age 4-8 might benefit with grommets

21
Q

glue ear and flying?

A
  • need to be careful - might have rapid expanding air from pressure changes
  • can use ear planes
  • suck lollipops/milk
22
Q

peaks of incidence for acute otitis media?

A

6-12 months

4-5 years

23
Q

management of acute otitis media?

A
  • 60% of patients pain-free within 24 hours, give pain relief
  • review in 2-3 days: if pain no settled: give antibiotics
24
Q

how long to use Abx for acute otitis media?

A

8-10 days

25
Q

exceptions for acute otitis media treating with ABx?

A
  • children under 2
  • cochlear implant
  • unlikely to come back for follow up
26
Q

complications of acute otitis media?

A
  • facial palsy: urgent grommet

- mastoiditis

27
Q

what is considered recurrent acute otitis media?

A

3 or more in past 6 months

28
Q

what is myringoplasty?

A

grafting ear drum

29
Q

mastoiditis Rx?

A
  • if early, Abx

- send to hospital

30
Q

when to refer for acute otitis media?

A
  • chronic, more than 3 months
  • suspect cholesteatoma
  • hearing loss
31
Q

what is cholesteatoma?

A

squamous cells bundle

32
Q

what does congenital cholesteatoma look like?

A

white pearl behind intact ear drum

33
Q

cholesteatoma formation?

A
  • retraction pocket
  • chronic discharge for year
  • MUST refer
34
Q

classic presentation of cholesteatoma?

A

middle ear infection, chronic, due to pocket

35
Q

dangers of cholesteatoma?

A
  • erode through bone and nerves

- brain abscess

36
Q

treatment of choice worldwide for severe cholesteatoma?

A

modified radical mastoidectomy

37
Q

big cholesteatoma surgery in australia

A

combined approach tympanoplasty

38
Q

otitis externa bacterial presentation and treatment?

A 
swollen canal
smelly
painful
Rx
ciloxin
Sofradex for 1/52
39
Q

otitis externa fungal presentation and treatment?

A 
spores
white blotting paper
Rx
locacortin oviform drops
kenacomb
nil stat
1/12

Sydney Child Health Program (113 decks)

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