ENT Flashcards
otitis externa
presentation
ear pain
itchy
discharge
conductive hearing loss
otitis externa
risk factors
‘swimmers ear’ - excessive moisture in the ears, not drying them well enough
trauma (cotton bud use)
removal of ear wax (ear wax can protect against infection)
otitis externa
causes/causative organisms
bacterial:
pseudomonas aeruginosa: gram-negative aerobic rod-shaped bacteria, likes to grow in moist, O2 rich areas
staphylococcus aureus
fungal : candidia, aspergillus
eczema
dermatitis (contact, seborrhoeic)
otitis externa
investigating/diagnosing
otoscopy (red, inflammed, discharge, tenderness)
swollen lymph nodes ear swab (causative organism)
otitis externa
management
mild: acetic acid 2% (antifungal & antibacterial, can be used prophylactically before and after swimming)
moderate: topical antibiotic and steroid (eg. gentamycin + hydrocortisone)
aminoglycosides eg. gentamycin are ototoxic so must exclude a perforated TM before using topical gentamycin
severe/systemic symptoms: oral antibiotics (eg. flucloxacillin) or IV abx if indicated by ENT
otitis externa
main complication to consider
malignant otitis externa
malignant otitis externa
pathophysiology
infection in ear canal spreads to the bones surrounding it and skull, cauing osteomyelitis of the temporal bone
malignant otitis externa
presentation
severe ear pain
persistent headache
fever
malignant otitis externa
risk factors
diabetes
immunosuppressant medications
HIV
malignant otitis externa
examination/diagnosing
otoscopy: granulation tissue found at the junction netween bone and cartilage in ear canal
malignant otitis externa
management
admit to hospital
IV abx
CT/MRI head to assess extent of damage
malignant otitis externa
complications
facial nerve damage and palsy
other cranial nerve involvement
meningitis
intracranial thrombosis
death
acute otitis media
presentation
ear pain
hearing loss/reduced hearing in affected ear
unwell, fever
URTI symptoms (cough, sore throat)
acute otitis media
causative organisms
streptococcus pneumoniae
staphylococcus aureus
haemophilus influenzae
moraxella catarrhalis
acute otitis media
risk factors
recent viral resp infection
immunocompromised
young age FHx
