Ear Emergencies ☺️

Question 1

Sudden Sensorineural Hearing Loss

• presentation
• investigations
• management

Answer 1

Sudden progressive loss

Tuning fork tests
-negative Rinne, positive Weber on unaffected ear

ENT emergency clinic
-PO 1mg/kg

Question 2

Foreign bodies

• population in which this is common
• management

Answer 2

Children

Insects => oil
Try to remove FB carefully

Refer to avoid harm caused by clumsy removal attempts

Question 3

Otitis externa

• presentation
• etiology and causative organism
• management

Answer 3

Pain, discharge

Swimmers, local trauma => pseudomonas

Topical ABx, steroid drops
Keep ear dry
Microsuction of pus

Refer if no resolution

Question 4

Otitis media

• presentation
• investigation
• etiology and causative organism

Answer 4

Young children

• acute pain => tug at ear
• bulging eardrum, discharge if perforated
• inflammed eardrum
• hearing loss
• recent URTI symptoms

Otoscopy

• bulging eardrum => light reflex lost
• red eardrum
• discharge

URTIs spread to middle ear via auditory tube
-S pneumoniae, H influenza, M catarrhalis

Question 5

Otitis media

• management
• complications

Answer 5

Analgesia, self limiting
ABx - amoxicillin/erythromycin in penicillin allergy
-perforated
-U2, bilateral OM
-IC, high complication risk
-systemically unwell
-symptoms 4+ days

Brain abscess, meningitis, mastoiditis, VII paralysis