Ear Flashcards
What are the symptoms of AOE?
- Swelling
- Itching
- Watery ear discharge
- Otalgia (earache) and tenderness
- Ear canal oedematous and tender
- Pre and post auricular lymph node swelling
What are the risk factors for AOE?
- Instrumentation of the ear canal (cotton buds)
- Skin conditions (eczema or psoriasis)
- Allowing water to enter the ear
What can AOE cause?
- perichondritis
- cellulitis
- osteomyelitis/ malignant otitis externa
What are the common causative organisms of AOE?
- Staphylococcus aureus
- Pseudomonas aeruginosa
- Aspergillus niger
What is the management of AOE?
- Keep the ear dry
- Oral analgesia
- Topical antibiotics drop with a steroid
If an AOE infection is spreading, what is the management?
Flucloxacillin
What are the signs of osteomyelitis/malignant otitis externa?
- Granulation tissue at bone-cartilage junction of ear canal
- Facial nerve palsy
- Temp >39 °C
What are the symptoms of osteomyelitis/malignant otitis externa?
- Pain and headache
- Vertigo
- Profound hearing loss
What is the common pathogen causing osteomyelitis/malignant otitis externa?
pseudomonas aeruginosa
What are the common pathogens causing AOM?
- Strep pneumoniae
- Haemophilus influenzae
- Moraxella catarrhalis
What are the characteristics of AOM?
- Earache
- Ear discharge
- Hearing loss
- Fever
- Child
- Associated URTI
- Tympanic membrane inflammation
What is seen on otoscope in AOM?
- Red, yellow or cloudy tympanic membrane
- Mod-sev bulging of tympanic membrane
- Air-fluid level behind tympanic membrane
- Perforation and/or discharge in the external auditory canal
How do you manage AOM?
Analgesia
When do you give antibiotics for AOM?
- Symptoms >4 days or not improving
- Systemically unwell
- Immunocompromised/high risk of complications (heart, lung, kidney, liver or neuromuscular disease)
- <2yrs with bilateral otitis media
- Perforation and/or discharge in the canal
What is mucosal COM?
Perforated tympanic membrane allowing infection to develop in middle ear
What is squamous COM?
Cholesteatoma formation
What is the management for mucosal COM?
- No treatment as tympanic membrane will usually heal after 6-8weeks
- Antibiotics if following AOM
- Myringoplasty if does not heal alone
- Keep ear dry
What are the symptoms for squamous COM?
- Recurrent/chronic purulent ear discharge
- Uniltaeral conductive hearing loss/tinnitus
- Otalgia, vertigo or facial nerve involvement
What will you see with an otoscope in squamous COM?
- Ear discharge
- Deep retraction pocket with/without granulation tissue
- Crust/keratin in upper part of tympanic membrane
- Perforation
What are the symptoms of otitis media with effusion?
- Conductive hearing loss
- Poor speech development in children
- Mild intermitting ear pain
- Aural discharge
- Recurrent ear infections, URTI or frequent nasal obstruction
What will you see with an otoscope in otitis media with effusion?
- Effusion and air fluid levels/bubbles are visible
- Normal tympanic membrane landmarks
- Tympanic membrane is dull and slightly injected
What is a glomus juglare?
A vascular tumour the presents as a red mass behind an intact tympanic membrane
How does a glomus juglare present?
- Pulsatile tinnitus
- Vertigo
- Painless
- Paresis of CN IX-XI
