ENT conditions Flashcards
Otitis externa (swimmers ear)
=inflammation of the external ear canal. Estimated to affect 1% of the UK population each year. OE can be classified as acute and chronic
caused by: a result of natural defences being overwhelmed. The causes often include moisture in the ear canal that creates an ideal environment for bacterial growth, exposure to contaminated water, and damage to sensitive skin of the ear canal creating an opening for infection
patho: bacterial–> overgrowth of bacteria in the external ear canal often due to increased moisture in the ear canal, and/or local trauma which allows bacteria to enter through a break in the skin
fungal–> follow prolonged and extensive use of topical antibiotics with or without coritcosteroids
non-infectious–> skin conditions such as atopic dermatitis, psoriasis, and acne.
pop: all ages can be affected with highest incidence occurring in 7-12 year olds with increased presentation of OE in late summer.
risk factors: hot and humid conditions, swimming, old age, dermatological issues, narrow ear canals (i.e. down syndrome) previous ear surgery, previous radiotherapy to the head and neck, any history of immunosuppression including diabetes, previous topical treatments for OE or otits media
s&s: ear pain, discharge, itch, hearing loss, fever
management: majority of cases will improve within 48-72 hours of treatment initiation. Between 65-90% of patients with uncomplicated OE have clinical resolution within 7-10 days, regardless of the topical treatment used.
ddx: acute otitis media with tympanic membrane rupture resulting in otorrhoea; eczema, necrotising otitis externa (NOE)
Otitis media
=infection of the middle ear seeded from the upper respiratory tract through the Eustachian tube
caused by: infection/bacterium/virus resulting from another Illness e.g cold, flu or allergy
E.g RSV, streptococcus, pneumonia, haemophilis, influenza.
patho: Infection causes inflammation of the middle ear mucosa and inflammatory exudate in the middle ear space
risk factors: under 10, 6month-2years old, passive smoking, cleft palate, children in group settings
s&s: -Ear pain (otalgia), Tympanic membrane perforation, Decreased balance, Headache, Hearing disturbance, Discharge, Trouble sleeping, Loss of appetite
prognosis: very common and can resolve in 72 hours
ddx: Otitis externa
-Tympanosclerosis, Trauma, Bollous myringitis, OME, Foreign body
Eardrum perforation infection
=a rupture in the eardrum
caused by: Otitis media, Barotrauma, Acoustic trauma, Foreign objects, Severe head trauma
risk factors: young, increased air pressure, Loud speakers, trauma
s&s: Ear pain – otalgia, Hearing loss, Tinnitus, Vertigo, Nausea/vomiting, Drainage of pus/ blood
management: normally repairs quickly but if damage is big then it may need surgery.
ddx: Otitis media, Bullous myringitis, OME, Foreign bodies, Otitis externa, Tympanosclerosis
Ramsay hunt syndrome
=herpes zoster of the geniculate ganglion. It affects the facial nearby near one of the ears . There is a facial palsy with vesicles sound the external auditory meat us and/or soft palate.
caused by: anyone who has had chickenpox
risk factors: 60+, weak immune system, chickenpox before
s&s: Unilateral facial paralysis/weakness, Painful red rash with fluid-filled blisters on, in and around ear, Otalgia, Tinnitus, Hearing loss, Dry mouth or eyes, Vertigo, Decreased taste, Difficulty closing eyes
management: Untreated may cause permanent facial muscle weakness and loss of heating, but they can fully recover
ddx: Bells palsy, Herpes simplex, Lymes disease, Stroke
