42. Ear pain Flashcards
most common bacterial cause of otitis media
Strep pneumoniae, haemophilus influenzae, moxarella
causes of ear pain (otalgia)
external
- Otitis externa
- Foreign body
middle
- otitis media
- effusion associated with otitis media
- acute mastoiditis
referred pain
- temporomandibular joint (TMJ) arthritis)
- trigeminal neuralgia
- ramsay hunt syndrome
- adenoidectomy, infection or neoplasm
epidemiology auricualr haematoma
Auricular haematomas are common in rugby players and wrestlers
management auricular haematoma
Prompt treatment is important to avoid the formation of ‘cauliflower ear’.
Management
auricular haematomas need same-day assessment by ENT
incision and drainage has been shown to be superior to needle aspiration
features mastoiditis
otalgia: severe, classically behind the ear
there may be a history of recurrent otitis media
fever
the patient is typically very unwell
swelling, erythema and tenderness over the mastoid process
the external ear may protrude forwards
ear discharge may be present if the eardrum has perforated
management mastoiditis
IV antibiotics
complications mastoiditis
facial nerve palsy
hearing loss
meningitis
otitis media with the presence of swelling around the affected ear and displacement
mastoiditis
Otitis externa with worsening unrelenting pain despite strong analgesia
malignant otitis externa - rf urgerntly to ENT!
management of perforated tympanic membrane caused by barotrauma
no treatment is needed in the majority of cases as the tympanic membrane will usually heal after 6-8 weeks. It is advisable to avoid getting water in the ear during this time
myringoplasty may be performed if the tympanic membrane does not heal by itself
why can throat pain be reffered to the ear?
part of the glossopharyngeal nerve (CN IX) innervates the ear explains why a sore throat can give us referred pain to the ear
