ENT 2 Flashcards
otitis externa
cellulitis of the external auditory meatus (ear canal)
cellulitis of the external auditory meatus (ear canal)
otitis externa
otitis externa - history and clinical presentation
6
- swimming or water exposure
- frequent ear cleaning
- rapid onset
- otalgia
- itching
- fullness w/ or w/o hearing loss
otitis externa - signs of ear canal inflammation
4
- tragal and/or pinna tenderness
- canal edema and/or erythema
- otorrhea (drainage)
- TM erythema
otitis externa - img/testing
none usually reqd
POC glucose if concern for underlying DM or hx of uncontrolled DM
otitis externa - tx rx and duration
topical abx 7-10 days
polymyxin B/neomycin/hydrocortisone 4 drops (P 3 drops) q6h
ofloxacin 10 drops (P 5 drops) once daily
cipro/hydrocortisone 3 drops (P 3 drops) q12H
otitis externa - avoid aminoglycosides in who
pts with tympanostomy tubes or suspected TM rupture
mastoiditis
infection of the mastoid air cells, typically following AOM
infection of the mastoid air cells, typically following AOM
mastoiditis
mastoiditis - hx and clinical presentation
3
- recent OM
- fever
- otalgia
mastoiditis - physical exam
6
- signs of OM
- redness
- swelling
- tenderness
- fluctuance over mastoid process
- pinna may be displaced
mastoiditis - img/testing
none usually
mastoiditis - tx
refer to ED for all suspected cases - serious infection
septal fracture/hematoma
septal hematoma - blood that collects between septal cartilage and perichondrium within the nasal septum
blood that collects between septal cartilage and perichondrium within the nasal septum
septal hematoma
septal fracture/hematoma - can deprive…
septal cartilage of its vascular supply
septal fracture/hematoma - hx of
4
- trauma
- sports injuries
- recent nasal surgeries
- bleeding condition
septal fracture/hematoma - hematoma typically occurs when
24-72 hrs after trauma
septal fracture/hematoma - symptoms
3
- nasal obstruction is most common - may be bilateral
- pain
- rhinorrhea
septal fracture/hematoma - physical exam findings
5
- septal fx
- ecchymosis
- reproducible pain
- clear rhinorrhea
- crepitus
septal fracture/hematoma - external deformities
not always present
septal fracture/hematoma - complication of untreated septal hematoma
3
- ischemia
2 permanent necrosis - saddle nose deformity
septal fracture/hematoma - physical exam intervention
2
nasal speculum or otoscope
suction blood clots
septal fracture/hematoma - hematoma appears
3
bluish
boggy
may be soft/fluctuant on exam
