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KB - ENT > Ear Disease > Flashcards

Ear Disease Flashcards

1
Q

What is otitis externa?

A

acute inflammation of the meatus (outer ear canal)

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2
Q

What are the main bacterial causes of otitis externa?

A

pseudomonas

staph aureus

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3
Q

What is the clinical presentation of otitis externa?

A

discharge
itch
pain
tragal tenderness

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4
Q

What is the management of otitis externa?

A

cleaning EAC is key

topical antibiotic drops - gentamicin

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5
Q

When would the use of gentamicin drops be contraindicated in otitis externa? Why?

A

If the patient had a perforated ear drum or a grommet

Potential risk of ototoxicity (gentamicin = amino glycoside)

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6
Q

What is malignant/ necrotising otitis externa?

A

extension of OE into the bone surrounding the ear

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7
Q

What can malignant OE lead to?

A

temporal bone destruction and base of skull osteomyelitis

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8
Q

What is the main risk factor for malignant OE?

A

Diabetes - 90% of cases are diabetics

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9
Q

What is the most common organism in malignant OE?

A

Pseudomonas aeruginosa

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10
Q

What is the treatment of malignant OE?

A

surgical debridement, systemic antibiotics, specific immunoglobulins

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11
Q

What is acute otitis media?

A

Inflammation of the middle ear, usually following a viral URTI

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12
Q

What is the presentation of acute otitis media?

A

rapid onset of pain, fever and/or irritability, anorexia, vomiting

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13
Q

What causes pain in acute otitis media?

A

Bulging of the tympanic membrane - this eases if the drug perforates, assoc. with purulent discharge

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14
Q

What are some common organisms that cause acute otitis media?

A

Pneumococcus, H. influenzae, Strep pyogenes, Strep pneumonia

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15
Q

What is the treatment of acute otitis media?

A

60% resolve within 24 hours without antibiotic treatment
If not - amoxicillin (erythromycin if allergic)
optimise analgesia

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16
Q

When should you consider immediate antibiotic treatment in acute otitis media?

A

If the patient is systemically unwell or immunocompromised

If there is no improvement to the symptoms after more than 4 days

17
Q

What is chronic otitis media?

A

An ear with a TM perforation, as well as recurrent or chronic infection

18
Q

What are the symptoms of chronic otitis media?

A

hearing loss
otorrhoea
fullness
otalgia

19
Q

What are the different classes of chronic otitis media?

A

Benign/ inactive
Suppurative
Serous

20
Q

What is the treatment of chronic otitis media?

A

topical or systemic Abx, depending on the swab
aural cleaning
water precautions
surgery? - mastoidectomy, myringoplasty

21
Q

What is a cholesteatoma?

A

An abnormal collection of skin cells (squamous epithelium)

Destructive and expanding growth

22
Q

What is the cause of inflammation with a cholesteatoma?

A

Increased cell turnover and increased keratin production

23
Q

What are the symptoms of a cholesteatoma?

A

smelly discharge

gradual hearing loss

24
Q

What are some complications of a cholesteatoma?

A

meningitis, cerebral abscess, hearing loss, mastoiditis, facial nerve dysfunction

25
Q

What is the treatment of a cholesteatoma?

A

surgical removal

26
Q

What is otitis media with effusion? (OME, Glue Ear)

A

Inflammation of the middle ear accompanied by accumulation of fluid
without signs or symptoms of acute inflammation

27
Q

What are some risk factors for OME?

A 
Male
Smoking household
Atopy 
Downs syndrome 
Recurrent AOM or URTI
28
Q

What are the symptoms of OME?

A 
Deafness 
Speech delay 
Poor school performance (inattention)
Behavioural problems 
Balance problems
29
Q

What are the signs of OME?

A

TM retraction
Visible ME fluid or bubbles
Altered TM colour - grey, yellow, dull
Decreased TM mobility

30
Q

What kind of hearing loss do you get in OME?

A

Conductive

31
Q

What is the treatment for OME?

A

Watchful waiting - 60% resolved within 3 months
Surgery - insertion of a Grommet
Hearing aids - if surgery not accepted

32
Q

What is a Grommet?

A

Used in treatment of OME
Small tube that helps drain fluid and maintain pressure
NOT CURATIVE - helps with symptoms

33
Q

What is a vestibular schwannoma?

A

A benign, slow growing intracranial tumour that develops from the vestibular portion of the vestibulocochlear nerve/ CN VIII

KB - ENT (6 decks)

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