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VMS 3010 > Approach To Otitis Externa > Flashcards

Approach To Otitis Externa Flashcards

1
Q

What is otitis externa?

A

Inflammation of the outer ear canal

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2
Q

What does PSPP Stand for?

A

Primary, Seconday, Presdisposing, Perpetuating

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3
Q

What bacteria do we need to be worried about with secondary causes?

A

Pseudomonas aeruginosa

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4
Q

What are some examples of predisposing causes?

A

Conformation
Humidity
Inappropriate cleaning
Irritant treatments
Obstructive ear disease

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5
Q

What are some of the examples of perpetuating causes?

A

Inflammation
Impaired self cleaning
Narrowed lumen
Ulceration and oedema of ear canal
Connective tissue calcification
Tympanic membrane inflammation

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6
Q

How would you treat allergic dermatitis?

A

Identify the allergy
Clean ears
Treat the secondary infection

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7
Q

How would you treat a foreign body

A

Sedate or GA and remove
Irrigate and flush ear
Medication as needed

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8
Q

How would you treat immune mediated dermatitis?

A

Corticosteroids
May also need to treat any secondary problems

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9
Q

What is the function of corticosteroids?

A

Reduces inflammation in acute otitis externa
Limits the pathological process in chronic OE
Addresses pain

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10
Q

What is the purpose of ear cleaning?

A

Aids in examination
Removes wax harbouring microbes
Breaks up the biofilm

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11
Q

What is the most common ear cleaning treatment?

A
  • Ceruminolytics
  • Astringents
  • Antimicrobial agents
  • Honey?
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12
Q

What is TrizEDTA?

A

Disrupts the biofilm
Damages bacterial cell walls
non ototoxic
can be co-administered

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13
Q

When would you do ear flushing?

A
  • May be neccesary in initial OE therapy
  • Performed under GA
  • Visualise with a video-otoscope
  • Use a spruelle needle
  • Use sterile saline
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14
Q

What are the benefits of the ear cleaning?

A

Reduces microbial load
Cleans the ear canal of debris and allows better penetration
allows better visualisation of the ear canal

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15
Q

What is photodynamic therapy?

A

Uses porphyrins as photosensitising molecules- organisms are sesnitised by uptake of porphyrins and destroyed on exposure to white light

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16
Q

What are the three surgeries you may do for ear issues?

A
  • Lateral wall resection
  • Vertical canal ablation
  • Total ear canal ablation
17
Q

What is the follow up examination for otitis externa?

A

Usually need first visit after 3 days of oral cortisone
Re-evaluate 7-10 days once on topical treatment
Continue treatment until the primary causes are resolved or controlled

17
Q

What topical treatment should you use if the cytology is rods?

A
  • Framycetin, Gentamicin, Polymyxin B
18
Q

What topical treatment should you use if the cytology in otitis externa is cocci?

A

Florfenicol, Fusidic acid/framycetin/Polymyxin B/miconazole

can combine with an antiseptic ear cleaner

19
Q

What is the function of TrizEDTA?

A
  • Disrupts the biofilm
  • damages bacterial cell walls
  • non ototoxic
  • best given 20-30 minutes before other products
  • can also be co-administered
20
Q

What is the function of ear flushing?

A

May be necessary in initial OE therapy * Performed under GA
* Visualise with video-otoscope/otoscope
* Using a Spruelle needle /urinary catheter/nasogastric feeding tube, flush and aspirate fluid * Use sterile saline (or dilute chlorhexidine solution)

21
Q

What are the benefits of ear flushing?

A

Reduces microbial load
* Clears ear canal of debris and allows better penetration of topical drugs
* Affords better visualisation of ear canal –
helps to ensure nothing is missed and allows assessment of the TMF

22
Q

What is the effec of a lateral wall resection?

A
  • Improves drainage
  • gained access to polyps/ neoplastic lesions
23
Q

When would you do a vertical canal ablation?

A
  • Irreversible disease of vertical canal
    (unlikely scenario – likely to fail)
24
Q

When would you do a total ear canal ablation?

A

Chronic end stage otitis
* Neoplasia
* (Deaf)

25
Q

What are the most common ear cleaning fluids?

A
  • Ceruminolytics
  • Astringents or drying agents
  • Antimicrobial agents
  • Honey

VMS 3010 (102 decks)

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