Ear Disorders Lecture Powerpoint Flashcards
Cone of light orientation on the tympanic membrane
Lies anteriorally
Presenting symptoms of otitis externa (5) (one big one!)
- Ear pain
- Pruritus
- Discharge
- Hearing loss
- Tragus tenderness**
Antibiotic treatment for nonsevere cases (the overwhelming majority, not those that are refractive or do not respond) is typically ___ performed
empirically
Ear wick
Dropping topical antibiotics on a cloth used when delivery of the topical antibiotic is blocked or difficult to reach, acts as a folded up cloth to stick deep in the ear to reach the deep part of the external auditory canal
Ciprodex (ciprofloxacin-dexamethasone)
An antibiotic that is an excellent choice for otitis externa when unsure if tympanic membrane perforation exists and otitis media in patients with tympanostomies
3 types of cerumen removal
- Cerumenolytic agents (mineral oil, hydrogen peroxide, debrox)
- Irrigation (safe unless tympanic membrane is perforated)
- Manual (curettes, suction)
Children’s eustachian tubes run ____, predisposing them to otitis media
horizontally
Otitis media is typically treated immediately with antibiotics rather than not. This is because…
…it can result in difficulties reaching life milestones down the road (hearing loss leading to speech delay)
Acute vs serrous otitis media
Serous is sometimes seen at the beginning and end of acute otitis media infection as well as with allergies and thus does NOT require antibiotics
If a child has artificial ostomy in tympanic membrane (for recurrent ottitis media)***, you can treat otitis media from then on with…
…cipro or ofloxacin otic drops as it goes thru the open tubes to the infection
Tympanogram
High tech machine that produces a measure of pressure vs compliance (movement), should typically be within a normal range with normal peak around zero pressure (daPa), if peaks in negative indicative of eustachian tube dysfunction, if cannot move classically seen in otitis media
Common pathogens that cause chronic otitis media (3)
- Pseudomonas
- Staph aureus
- proteus
1st line and 2nd line treatment of acute otitis media
- Amoxicillin
- amoxicillin-clavulanate (augmentin) or 2nd gen cephalosporin
Tympanosclerosis
Scarring of the eardrum, diagnosed clinically via otoscopy, only affects hearing in high levels, rarely requires treatment
Barotrauma treatment
- Oral decongestants
- Swallowing or valsalva
- chewing gum or sucking on something (bottle in babies)
bilateral vestibular schwannomas are characteristic clinical features of…
…nerofibromatosis type 2
Neurofibromatosis definition and 3 types
A genetic condition that causes tumors to form in the brain, spinal cord, and nerves
Type 1 - causes skin changes and deformed bones. It usually starts in childhood,sometimes the symptoms are present at birth
Type 2 - causes hearing loss, ringing in the ears, and poor balance. Symptoms often start in the teen years
Type 3 - Schwannomatosis causes intense pain. It is the rarest type.
Ramsay Hunt’s syndrome (Herpes zoster oticus)
Invasion of 8th nerve ganglia and ganglion of facial nerve by the herpes zoster virus causing severe ear pain, hearing loss, vertigo, vesicles in the auditory canal and auricle, paralysis of the facial nerve, taste perception, hearing, and lacrimation
Meneire’s disease
Chronic condition with recurrent episodes of vertigo associated with sensorineural hearing loss, tinnitus, and or a sensation of aural fullneess, chronic condition with relief but no cure, paroxysmal lasting 20 min to 24 hours and subsiding gradually
Meneire’s disease treatment (3)
Medications such as diuretics or vestibular suppressants, or hearing aids/surgery
Hemotympanum
A common result from temporal bone fractures that can cause disruption of the ossicular chain and subesequent middle ear hearing loss requiring urgent referral, may also see “battle’s sign” - bruising behind the ear, requires urgent ENT referral to ensure no hearing loss occurs
90% of otitis externa is one of these 2 causative agents
- p. aeruginosa
- staph aureus
Otitis externa treatment options (4)
- ofloxacin otic
- ciprofloxacin otic
- corticosporin otic
- ciprofloxacin dexamethasone
gtts abbreviation
drops