Discharging Ear Flashcards
Presentation of a discharging ear
Deafness, otalgia (earache), otorrhea, dizziness, tinnitus, pruriti (itch), facial palsy
Presentation of Otitis Externa aka Swimmers ear
itchy then painful, hearing ok, painful to touch pinna
Common pathogens causing Otitis Externa
Staphylococcus Aureus and Pseudomonas Aeroginosa
Presentation of Acute Otitis Externa
Earache, cold, malaise and fever
Commonly affected by AOM
6-15 months
Treating AOM with intact eardrum
Paracetamol or Ibuprofen, delay antibiotics until day 4. 5 day course of amoxicillin for strep pneumoniae and haemophilus influenzae
Treating AOM with perforated eardrum
Eardrops
When to refer AOM to ENT
4 or more episodes each year
Risk factors for AOM
Young children, having a cleft palate and Down Syndrome
Why are children more prone to AOM
They have a short eustachian tube and have larger adenoids
Treating Chronic Otitis Media
Water precautions, topical therapy when needed, refer for myringoplasty
Acute Mastoiditis
Postauricular swelling and erythema without subperiosteal abscess or mastoid osteitis
Complications of Acute Mastoiditis
Meningitis, abscess, venous thrombosis, raised ICP
Treating Mastoiditis
Vancomycin and ceftriaxone
Cholesteatoma
Noncancerous skin growth that develops in the middle section of the ear behind the eardrum.
Cause of a Cholesteatoma
When eustachian tube is blocked, a partial vaccum forms creating a cyst. Growth becomes larger when filled with old skin cells and fluid.
Presentation of Cholesteatoma
smelly otorrhoea, intermittent, hearing loss
Complications of Cholesteatoma
vertigo, facial muscle paralysis, permanent hearing loss, meningitis, brain abscess
Treating Cholesteatoma
Surgery to remove
Necrotising Otitis Externa
An aggressive infection rather than a malignancy of the external ear
Who is commonly affected by Necrotising Otitis Externa
Over 90% of Diabetics
Risk factors for Necrotising Otitis Externa
Diabetics, those on chemotherapy, HIV, AIDS
Presentation of Necrotising Otitis Externa
smelly otorrhea, otalgia, hearing loss, itching near canal, fever, difficulty swallowing, weakness in facial muscles, loss of voice, swollen red skina around ear
Investigating Necrotising Otitis Externa
Swab for culture, neurological exam, CT, MRI of head,
