Ears - Ear pathologies Flashcards
What is pinna haematoma
Collection of blood
What is the issue w/ pinna haematomas (2)
can incr infection risk
Can –> cartilage necrosis –> cauliflower ear
Mx pinna haematoma
Rx ENT
Aspiration/drainage
What is Otorrhoea
Discharging ear
When to suspect necrotising otitis externa w/ otorrhoea
Unilateral severe ear pain
W/ foul discharge
CN palsies
What is a medical emergency in otology
Sudden SNHL
Mx Sudden SNHL (4)
Vasodilators
Carbon
Steroids
Aciclovir
TMJ dysfunction S+S
Pain anterior to tragus, worse on eating
Normal eardrum
Tender over TMJ
Misaligned, clicking bite
Hx points otorrhoea (8)
Duration of discharge Associated otalgia Systemic fever Sx Associated HL/dizziness FB in ear Any CN palsies Hx of trauma Recent topical Abx
Why ask about recent TO ABx in otorrhoea Hx
Predisposes to antifungal ear infection
What % of the pop suffer from otitis externa?
10%
What is otitis externa
External inflammation of the exterinal ear
PS Otitis externa (3)
Severe ear pain
Itching
HL
RF otitis externa (6)
Cotton buds h2o expsoure FB Warm/humid climates Underlying skin condition - eczema hearing aids
O/E otitis externa (3)
Tragus = tender
Red swollen canal
T M not visible
Complications of otitis externa (2)
Periauricular cellulitis
Necrotising otitis externa
Causative organisms otitis externa (3)
Pseudomonas
Staph
Strep
Tx Otitis externa - simple
GP + TO Abx
Tx of complex otitis external
Aural toilet
Steroids
TO antifungals/Abx
PO flucloxacillin if really bad
DDx otitis externa (3)
Malignant OE
Mastoiditis
Pinna perichondritis
Who gets Nec OE (3)
Elderly
DM
Immunocomp
Cause of nec OE
Pseudomonas
What palsies can nec OE cause? (4)
8
9
10
12
Worst outcome nec OE
death
Tx Nec OE (3)
High dose ciprofloxacin
facial debridement
refer
What is Otitis media
Inflammation of the middle ear
Cause of OM?
URTI –> obstruction of eustachian tube
Sx OM in an infant (4)
Fever
Ear pulling
Irritable
Vomiting
Sx OM in a child/adult (5)
Otalgia Fever Malaise Hearing loss Bulging T M
Another name for OME
Glue ear
What is Glue Ear
Sterile collection fluid in middle ear
Causes Glue ear (3)
Infection/allergy
AOM
ET dysfunction
Who gets affected by Glue ear? (3)
Children w:
Large adenoids
Cleft Palate
Downs syndrome
Sx glue ear (3)
Painless HL
Poor speech development
T M dull +/- fl level
Tx glue ear (6)
Most = W+W Eval at 3 months If not gone away - grommets Ab Adenoidectomy to reduce recurrence
Fct of grommets (2)
Aerate middle ear
P equaliser
What is AOM
Bacterial infection of the middle ear
Causative agents AOM (2)
Strep
Hib
Sx AOM
Pus –> inflammed –> bulging ™ –> pain, fever and reduced hearing
Rupture –> blood and pus into EAM
How long does it take the ear drum to heal after AOM rupture
4-5 days
Tx AOM (4)
Augmentin
Analgesia
Myringotomy if fails to resolve
Nasal decongestants
What is chronic suppurative OM
Repeated infection –> microabscesses and inflammatory cells infiltrating
+/- perf
PS chronic suppurative OM (2)
Odourless discharge
Conductive HL
Tx chronic suppurative OM (6)
H2O avoidance Few weeks to heal Cipro + steroid drops Hearing aids May have to repair surgically
What is a cholesteatoma?
Meatal skin protrudes –> production of keratin –> forms a bag –> cyst
Where does cholesteatoma occur
In attic/epitympanic recess
Sx cholesteatoma (4)
Foul discharge
Conductive HL
Attic retraction
Aural polyps
Cholesteatoma erosion into cochlea - Sx
SN deafness
Cholesteatoma erosion into ossicles - Sx
Conductive HL
Cholesteatoma erosion into SC canal Sx
Vertigo
Cholesteatoma erosion into roof
IC abscess.
Sepsis
Ix cholesteatoma (2)
CT scan temporal bone
PTA
Tx cholesteatoma
Surgery