Ear

Question 1

Otitis externa

Answer 1

• Is an inflammatory reaction of the meatal skin.
• Many cases recover after thorough cleansing of the external ear canal by suction or dry mopping. A topical anti-infective e.g. Neomycin sulfate or Clioquinol may be used, but for ONLY for a week as excessive use may cause fungal infections.
• Solutions containing an anti-infective and a corticosteroid are used to treat infections with inflammation and eczema.
• Topical aminoglycosides or polymyxins are CI in patients with a perforated tympanic membrane (eardrum) or patent grommet.

Question 2

Otitis media

Answer 2

• Acute otitis media is the commonest cause of aural pain in small children, it is a self-limiting condition
• Most uncomplicated cases resolve within 3-7 days without anti-bacterial treatment and a simple analgesic e.g. Paracetamol may be sufficient. A systemic antibacterial may be started after 72 hours if there is no improvement or earlier if there is deterioration.
• Children with acute otitis media usually present with symptoms such as ear pain, rubbing of the ear, fever, irritability, crying, poor feeding, restlessness at night, cough, or rhinorrhoea.
• Perforation of the eardrum in patients with acute otitis media usually heals without treatment, however if no improvement e.g. pain or discharge, then an anti-bacterial can be given.

Question 3

Otitis externa OTC treatment

Answer 3

Acetic acid 2% (ear calm spray) acts as an antifungal and antibacterial in the external ear canal. It may be used to treat mild otitis externa. Available OTC