Ear Disorders 1 Flashcards
(38 cards)
What is the physiology behind cerumen
Helps protect external ear from foreign bodies and water
What are clinical presentations of Cerumen Impactions
Hints: Think Q-tips
Hearing loss Earache Reflex cough (CN X) Dizziness Tinnitus
What are the treatments for Cerumen impactions?
- Detergent ear drops
- Mechanical removal
- Water (body temperature) irrigation
When should you only irrigate an ear canal?
Only when tympanic membrane is intact
How do you remove a firm object from the ear?
How about organic foreign bodies
- Remove using a loop or hook or irrigation
2. Do not irrigate and immobilize insects with lidocaine
What is the bacteria that causes Otitis Externa “swimmers ear”
Pseudomonas proteas
During an Pneumatic Otoscope exam, what would you find in someone with Otitis Externa
TM will move normally
What medications are prescribed to treat Otitis Externa?
- 7-10 days with topical Aminoglycoside or Fluoroquinolone with or w/o corticosteroids
- Keep ear canal dry and away from moisture
What is the treatment for Hamatoma of External Ears
Drainage to prevent ear deformities/blockage and to prevent Cauliflower ear via cartilage discharge
What are the most common organisms that cause Acute Otitis Media
- Streptococcus pneumonia
2. Haemophilus influenza
How does a TM present during Acute Otitis Media
Immobile with erythema and bulging
May also rupture
What is the 1st line treatment for Acute Otitis Media?
What is the 2nd line?
Amoxicillin
Amoxicillin-clavulanate
What is a good prevention measure for acute otitis media
Pneumococcal vaccinations
Complications of Acute Otitis Media?
- Mastoiditis
- Non-responsive to meds (resistant organisms)
- Reoccurring infections (might indicate the need for ear tubes
What is the etiology behind Serous Otitis Media aka Otitis media with Effusion?
- Eustachian tube stays blocked for prolonged period of time.
- Negative pressure causes transudation of fluid into the middle ear
When does a foreign body in the ear become urgent?
- If its is a button battery (children)
- Live insects
- Penetrating FB
How is Otitis Externa characterized?
Inflammation of the external auditory canal
How does Otitis Externa present?
- Otaligia (earache)
- Pruritis (itching)
- Purulent discharge
- Hearing
- Fullness
How does Otitis Externa present during a Physical Exam
- Erythema and edema of ear canal
- Tenderness while pulling the auricle
- TM is erythematous but moves normally during pneumatic otoscopy
Differential diagnosis with Otitis External
- Contact dermatitis
- Psoriasis
- Squamous cell carcinoma of the external canal
- Ramsy Hunt syndrome- HSV causing vesicles on th out ear canal
What is a complication of Otitis Externa
- Periauricular cellulitis
- Contact dermatitis from antimicrobials (neomycin)
- Malignant Otitis externa- osteomielitis of temporal bone/skull
How is Otitis media with a perforated TM treated?
- Topical antibiotic with low ototoxicity- Oflaxacin
- Analgesics
- Prevention- Pnneumoccocal vaccinations
Guidelines for Observation of Acute otitis Media, NOT antibiotics
- Children 6 months - 2 y.o. with unilateral AOM and mild symptoms
- Greater than or equal 2, unilateral or bilateral AOM but not severe
* Give antibiotics if condition gets worse and doesn’t improve in 48-72 hrs
Guidelines to give Antibiotics for Acute Otitis Media
- Children < 6 months
- Children < 24 months if:
- Moderate to severe pain
- Pain for 48hrs or more
- Fever of 102.2 or greater
- Bilateral Acute Otitis Media
