ENT Flashcards
What are the three main Tx of cerumen impaction?
ear drops
irrigation (warm water directed towards posterior canal w/ TM visible and dry after)
suction- refer to ENT
What is the mainTx of a foreign body in EAC?
remove with hook
if an insect, utilize lidocaine or mineral oil
don’t use water for organic materials
What is the first line Tx of otitis externa?
ear drops for 7-10 days, 5+ drops 3-4x daily
What are the two most common Abx ear drop treatments for otitis externa caused by bacteria?
neomycin (polymyxin B, hydrocortisone)
ciprodex (ciprofloxacin, dexamethasone)
What are the two most common ear drop Tx of otitis externa caused by fungi?
clotrimazole (Lotrimin) 1% solution
acetic acid (white vinegar)
If the ear canal is swollen shut, how can drops to treat otitis externa be administered?
by placing a cotton wick into the canal
What is the first line Tx of malignant otitis externa in adults?
IV Abx- fluoroqinolones (ciprofloxacine)
What is the first line Tx of malignant otitis externa in peds?
IV Abx- cephalosporins
What is the main Tx of pruritis of the external ear?
oil drops
(topical steroids may be used with inflammation but this is atypical)
What are some of the main conservative measures of TMJ Tx?
*NSAIDs x 10-15 days
avoid chewing gum or fingernails
soft food diet
avoid grinding teeth
massage, heating pad
What are some of the Tx measures for chronic TMJ pain/ bruxism
muscle relaxers (combo w/ NSAIDs)
neuropathic pain meds (TCA: nortriptyline or amitriptyline; gabapentin)
corticosteroids
CBT
PT
acupuncture
What are two treatments of cholesteatoma?
surgery- mastoidectomy
ABx steroid drops to reduce inflammation and granulation (refer to ENT)
What is first line Tx of AOM in adults?
amoxicillin
What are some alternative Abx to amoxicillin in AOM Tx in adults?
amoxicillin- clavulanate
cefuroxime
cefpodoxime
What are 2 Tx for recurrent AOM in adults?
long-term abx prophylaxis (sulfamethoxazole or amoxicillin)
tubes
What would you use for AOM pain management in children?
tylenol and ibuprofen (if older than 6 months)
What 3 Abx are used for children with AOM?
amoxicillin (if haven’t received in 30 days)
amoxicillin-clavulanate- amox in past 30 days, concurrent purulent conjuctivitis, recuurent AOM
cephalosporin (cefdinir, ceftriaxone)- PCN allergy
What children receive 10 days of Abx Tx for AOM?
children younger than 2
those with severe symptoms
What children receive 7 days of Abx Tx for AOM?
2-5 yrs
those with mild or moderate AOM
What children receive 5-7 days of Abx Tx for AOM?
children 6 yrs or older
mild or moderate AOM
Tx for children with recurrent AOM includes what?
tympanostomy tubes and adenoidectomy
(prophylactic abx not recommended)
Prevention of AOM in children includes what?
PCV vaccine
influenza vaccine
avoid smoke exposure
tympanostomy tubes
encourage breastfeeding
What is first line tx of chronic OM?
topical otic abx (w/ dexamethasone)
ofloxacin or ciprofloxacin
What is the second line tx of chronic OM?
systemic abx
oral ciprofloxacin
