Ear disorders Flashcards
hematoma formation in subperichondrium
Auricle Trauma–> cauliflower eat if not tx promptly
- can treat with abx in case infection from S. aeurus (MRSA)
- I&D and pressure dressing
inflammation of auricle cartilage
pathogens:
perichondritis
pathogens: pseudomonas, staph, strep pyogenes
difference between perichodritis and polychondirits
peri- one area and infectious (Pseudomonas, Staph, Strep Pyogenes
Poly- diffuse cartilaginous areas; AUTOIMMUNE mediated
a sudden or gradual loss of hearing usually self-induced
Treatment?
cerumen impaction
Cerumen softening agent: -3%H2O2 -debrox OTC (earwax removal drops) - sweet oil OR curette OR suction and irrigation w 50/50 mix of H2o2 and warm H20
corticosteroids are used to treat—
inflammation
what medication is given when bacteria is the cause
antibiotic: mainly Fluoquinoles like Cipro
inflammation of the EAC
otitis externa
pathogens for otitis externa
s. Aureus, pseudomonas, fungal (10%)
1st line treatments for otitis externa “swimmers ear”
ciprodex ($$$)4 drops for 7 days
OR
ofloxacin 0.3% 10gtts once a day x7days
treatment of fungal infection
clotrimazole 1% soln
invasive infection of EAC and skull base (pathogen?)
malignant otitis externa; pseudomonas
if TM is ruptured you would avoid what medication?
corticosteroids
entrapment of air within the middle ear causing failure of tube opening for ventilation
tx?
etiology:
Eustachian tube dysfunction
- tx underlying cause
- valsalva
- URI, viral,, allergies, younger pos due to underdevelopment
INJURY via change in atmospheric pressure i.e. flying or diving caused by ear tube dysfxn
otic barotrauma
infx of middle ear causing bulging TM, redness, and decrease in mobility
state pathogens
Acute otitis media
pathogens: Pneumonnia*** MOST COMMON,
H. influenza, M. catarrhalis, S. aureus
-viral (less common)
medication for Acute Otitis Media
- Amoxicillin 80-90 mg/kg BID 5-10 days
- augmentin if amoxicillin FAIlS
- Allergic—> Macrolides (Azithro or Erythromycin)
2nd line: augmentin, ceftan, omnicef
what medication is given to those allergic to penicillins
Macrolides: ACE
Azythro
Clar
Erythromycin
otitis media with effusion; hypomobile TM
Serous otitis media
TM perforation failure to heal after an AOM
and treatment
chronic supporative otitis media ‘TUBOTYMPANIC”
-tympanoplasty
CSOM pathogens
Psodomonas a., Staph aureus, Proteus
Abnl accumulation of squamous epithelial in middle ear and mastoid destroying ossicles —> conductive hearing loss
Cholesteatoma
- cn7 affected
- inward creating sac lined w SCC that become infx
What’s Bullous myringitis a variant of and how would you treat it?
codones for pain
-same as AOM–
same pathogens! Strep pneumonia, H. flu, M. catarahlis, S.aeurus
most frequent complication of middle ear infx with postaurical pain and erythema, fever,
tx
Mastoiditis
IV abx ceftriaxone
or myringotomy or mastoidectomy
two conditions due to trauma:
- blood accumulation behind ear___
- discoloration behind ear indicative of basilar skull fracture
Hemotympanum
Battles sign
Ramseys hunt sx & treatment (4)
herpes zoster oticus: shingles of facial nerve
- facial paralysis and hearing loss
- Acyclovir, vala, fam (viral tx)
- prednisone (corticosteroids boost effect of antiviral drugs)
- diazepam (anxiety)
- narcotics (pain)
medication for anxiety/relieve vertigo
diazepam,
meclizine, scopalamine,
antihistamine and or antiemetics
two types of tinnitus
pulsatile and clicking= staccato
sensation of motion
vertigo
types of vertigo and which is more dangerous
- peripheral: sudden, horizontal nyst. BPPV, Menderes etc
- central** : gradual and vertical nystagmus (usually from braistem)
maneuver to diagnose and see nystagmus
-maneuver to TREAT(get otolith back in place)
Dix-Halpike vs Epley
short episodes of vertigo brought on by head movement
& treatment
Benign paroxysmal positional vertigo (BPPV)
*epley maneuver
tetrad for Maniere’s disease
- vertigo
- hearing loss
- tinnitus
- aural pressure
increase volume of lymph fluid
Meniere’s disease
vascular compression of vestibular nerve causes
permanent/CONSTANT form of positional vertigo and severe nausea
what makes vestibular neuritis/neuropathy different?
treatment?
nerve inflammation/vertigo WITHOUT cochlear/hearing loss
supportive care, tx sx
Most worrisome and most common intracranial tumors and sx
Acoustic neuroma aka benign schwannoma of CN VIII
- a peripheral lesion
- asymmetric or unilateral hearing loss, tinnitus, vague vertigo
difference between hearing loss:
- conductive
- sensory
- neural
- ototoxic
- conductive: problem of external or midd ear affecting sound traveling to inner ear due to obstruction,URI
- sensory: cochlear deterioration from hair cell loss most commonly by presbycusis
- neural: lesions of CNVIII (least common)
- ototoxic: secondary to RX
