ENT Flashcards
What is otitis media and otitis externa?
media: middle ear inflam
externa: meatus inflam
presentation of acute and chronic otitis media?
acute
- pain, fever
- anorexia and vomiting
Chronic
- pain
- hearing loss
- otorrhoea
- fullness
Management of acute otitis media
analgesia
amox if systemically unwell, immunocomp, no improvement in 4 days
Management of chronic otitis media
topical/systemic abx
aural cleaning
water precautions
surgery - myringoplasty: repair tympanic membrane
mastoidectomy
difference between acute and chronic otitis media
chronic is ear with tympanic membrane perforation in setting of recurrent or chronic infections
acute is middle ear inflam
Risk factors for otitis media
bottle feeding
dummy/pacifier
Adenoids
Asthma
Passive smoker
UTRI
GORD
Causes of acute otitis media
pneumococcus, haemophilus, moraxella
Causes of otitis externa
Excess moisture in canal, trauma, high humidity, hearing aids
Pseudomonas most common organism
Symptoms of Otitis externa
discharge, itch, pain, tragal tenderness
normal, narrowed or occluded external auditory canal
Management of otitis externa
Clean EAC
mild: hydrocortisone cream and earcalm spray
Mod: otosporin
severe: thin ear wick to allow meatus opening for microsuction or cleansing
How to remove foreign body from ear
soft: crocodile forceps
hard: wax hook beyond object
first removal attempt will be the most tolerated so if anxious or awkward refer to ENT
Causes of referred ear pain
CN V: dental disease and TMJ dysfunction
CN VII: geniculate herpes
CN IX/X: posterior 1/3rd of tongue, pyriform fossa, larynx, throat (tonsillitis)
C2 C3: neck soft tissue injury and cervical spondylosis/arthritis
TMJ presentation/signs/Rx
Px: earache, facial pain, joint clicking
Signs: joint tenderness
Rx: self limiting
