Diseases Of External Ear Flashcards
Congenital abnormalities of pinna
Anotia Microtia Macrotia Bat earcup / Lop ear Cryptotia Coloboma Ear lobule deformity Pre auricle tags / appendages Pre auricular pits / Sinus
Minor deformities of pinna
Darwin’s tubercle
Stahl’s ear
Satyr ear
Trauma to the pinna (auricle)
Haematoma Lacerations Avulsion Frostbite Keloid
Inflammatory disorders of the pinna
Erysipelas
Cellulitis
Perichondritis
Relapsing polychondritis
Chondrodermatitis nodularis chronica helicis
Tumors
Galium 67 used in malignant otitis externa
Detect soft tissue infection
Taken up by monocytes + reticuloendothelial cells
Technitium 99 used in diagnosis
Bone infection in malignant otitis externa
Results positive for 1 yr
Arnold’s nerve
Auricular branch of vagus nerve(X)
Swimmer’s ear
Otitis externa
Otitis externa /swimmer’s ear causes
Bacterial (pseudomonas, E coli,S. Aureus)
Fungal (candida, aspergillus)
Dermatological (alllergic contact dernatitis, psoriasis, atopic dermatitis
Diabetes
Signs of swimmer’s ear/ititis externa
Pinna traction
Otorrea (yellow discharge)
Swelling purulent debris (canal obstruction)(conductive hearing loss)
Post. Auricular lymphadenopathy
External ear canal pruritis
Complicated otitis externa signs
Periauricular soft tissue erythema
Swelling
Hearing test in otitis externa/swimmer’s ear
Weber test (sound lateralized to affected ear) Rinne test (BC > AC)
Signs of otitis externa /swimmer’s ear
Ear pain(otalgia) Discharge/debris (yellow ,white,gray) Pruritis Tinnitus Hearing loss Lymphadenopathy Fever External auditory canal occluded (erythematous+edematous)
Types of otitis externa (eitiological)
Infective
Reactive
Infective type of Otitis Externa include
Bacterial Furuncle/localized OE Diffuse OE Malignant OE Viral Herpes zoster oticus OE haemorrhagica Fungal Otomycosis
Reactive type of otitis externa include
Eczematous OE
Seborrhoeic OE
Neurodermatitis
Herpes zoster oticus
Vesicles on tympanic membrane Meatal skin Concha Postauricular groove 7th + 8th nerve involved
Otitis externa haemorrhagica
Haemorhhagic bullae on tympanic membrane
Deep meatus
Severe pain
Blood stained discharge(bullae rupture)
Furuncle /Localized Acute OE
Staph. infection of hair follicle Furucle only in meatus Single/multiple Severe pain Tenderness Painful pinna movement Painful jaw movement Edema over mastoid (post meatal wall)
Treatment of Furuncle OE
10% Ichthammol glycerine
Provide splintage and reduces pain
Diffuse OE
Diffused inflammation of meatal skin
Pinna + epidermal layer of tympanic membrane
Excessive sweating changes pH of meatal skin (alkaline)
Leads trauma + invasion of pathogens
Phases of Diffuse OE
Acute
Chronic
Acute phase Diffuse OE
Hot burning sensation Pain (jaw movement) thin serous discharge (thick+purulent) Meatal lining (inflammed+swollen) Conductive hearing loss(oclusion) Lymph nodes swell +tender(cellulitis)
Chronic phase of diffuse OE
Irritation
Itching
Discharge scanty (dry crusts)
Meatal skin (thick + swollen + scalling + fissuring)
Chronic stenotic OE(hypermetropic meatal skin)
Malignant /necrotizing OE
Pseudomonas infection Elderly diabetics / immunosuppressive Excruciating pain Granulation in ear canal FACIAL PARALYSIS SPREAD Skull+jugular foramen(nerve palsies) Ant. Temporomandibular fossa Post. Mastoid Medially middle ear+petrous bone Severe otalgia
Fungal OE /otomycosis
Aspergillus niger, fumigatus, candida Tropical and subtropical Intense itching Pain Watery discharge (musty odour) Ear blockage Fungal mass (white/brown/black) Meatal skin red + edematous
Antifungals (nystatin,clotrimazole,povidone iodine)
Keratolytic (2% salicylic acid)
Eczematous OE
Hypersenstivity to organisms/ear drops(neomycin) Allergic reaction(hearing aids) Intense irritation Vesicle formation Canal crusting+oozing
Seborrhoeic OE
Seborrhoeic dermatitis of scalp
Itching
Greasy yellow scales (canal+lobule+postauricular sulcus)
Neurodermatitis
Compulsive scratching (psychological)
Intense itching
Bacterial infection may follow
Area of collection in canal/blind pocket
Anteroinferior meatal recess
Ear toilet
Blind spot specially
Dry mopping
Suction clearance
Irrigation (warm sterile normal saline)
Medicated wicks
Gauze wick Soaked in antibiotic steroid
2-3 times a day
Local steroid drops releive edema, erythema and prevent itching
Aluminium acetate 8% ,silver nitrate 3% mild astringents (dry up oozing meatus)
Antibiotics for treatment of malignant/necrotizing OE
Gentamicin+ticarcillin IV
(Ototoxic+nephrotoxic)
Cephalosporins(ceftriaxone/ceftazidime)
Quinolones+rifampin
Primary cholesteatoma of EAC
Squamous epithelium invades bone Abnormality conductive for epithelium Post traumatic /post surgical Starts from posteroinferior part of ear canal Purulent otorrhoea Pain Granulation(sequestrated bone)
