Head + Neck Conditions and Treatments Flashcards
What is auricular haematoma?
Collection of blood under the skin of the outer ear - if not drained or treated then get cauliflower ear
Pain, swelling, bruising
What is the treatment for auricular haematoma?
Incision and drainage
Pressure dressing and possible antibiotics
What is acute otitis externa?
Inflammation of external auditory meatus - pseudomonas aeruginosa
Itch, pain and discharge
What is the treatment for otitis externa?
Antibiotic or steroid ear drops.
Sofradex, Gentisone HC or Otomize spray
Cilodex if perforated
Fungal - clotrimazole or Nystatin
What is malignant otitis externa?
Osteomyelitis of temporal bone - risk of spreading to skull
Diabetic or immunosuppressed patients
Granulation tissue in EAC
What is the treatment for malignant otitis externa?
Antibiotics needed for weeks or months
Anti-pseudomonas antibiotics for 4-6 weeks
What is otitis media with effusion?
Glue ear - sterile fluid in middle ear as impaired eustachian tube so low pressure
Loss of hearing and seen on otoscope
What is the treatment for otitis media with effusion?
Observation for 3 months
May need otovent or grommets inserted
What is acute suppurative otitis media?
Pus in the middle ear - otalgia and otorrhea
Fever and bulging membrane
What is the treatment for acute suppurative otitis media?
Observation and pain killer
Wait and review then possible antibiotics
What is tympanosclerosis?
Calcification in tympanic membrane and maybe in middle ear - thickening of the drum
Usually asymptomatic but can have hearing loss
What is the treatment for tympanosclerosis?
Usually none
Only need if hearing loss - myringotomy
What is a cholesteatoma?
Abnormal collection of skin cells in middle ear
Rare and if left untreated can damage ear
Offensive otorrhea + hearing loss
What is the treatment for cholesteatoma?
Mastoidectomy to remove cholesteatoma
What is otosclerosis?
Irregular bone remodelling - growth in middle ear causing hearing loss
Conductive hearing loss
What is the management for otosclerosis?
Hearing aid and stapedectomy
What is the treatment for facial nerve palsy?
Treat underlying cause
Steroids and eye car
If Bells palsy - prednisolone
What is Benign Paroxysmal Positional Vertigo (BPPV)?
Repeated episodes of vertigo caused by loose otoconia moving out of utricle into semi-circular canal
Vertigo and nystagmus
What is the treatment for BPPV?
Dix-Hallpike is diagnostic
Espley manoeuvre is treatment
What is vestibular neuronitis?
Inflammation of vestibular nerve - acute vertigo which can last for hours
Nausea and vomiting
What is the treatment for vestibular neuritis?
Anti-nausea medication
Anti-viral drugs - acyclovir
Corticosteroids
What is Meniere’s disease?
Rare condition of inner ear - vertigo, hearing loss + tinnitus. Also feeling of fullness in ear.
What is the treatment for Meniere’s disease?
Beta-histamine - vasodilator
Stemetil PRN - antiemetic
What is epistaxis?
Nosebleeds
Commonest site is little’s area - Kiesselbach on anterior
Posterior - Woodruff
What is the management/ treatment for epistaxis?
First aid compression and head tilt - 10-15 mins
Cotton wool with adrenaline or nasal cautery with silver nitrate
Then nasal balloon catheter
What is the management and treatment of orbital cellulitis?
IV antibiotics
Nasal decongestants
CT scan and possible surgical drainage
What is the treatment of acute sinusitis?
Symptomatic relief with pain killers
If no improvement - topical steroids
Then antibiotics
What is the treatment of a periorbital abscess?
Emergency referral
Urgent Ct and IV antibiotic
Drain pus from outside or endoscopically
What is a ethmoidal mucoceole?
Mucous cyst of paranasal sinus - ethmoidal air cells
Commonly asymptomatic but can have visual impairment
What is the treatment for ethmoidal mucoceole?
FESS - drainage by surgery
What are nasal polyps?
Painless soft growths inside the nose - asthma and aspirin sensitivity
Blocked nose, PN drip, nasal discharge, and hyposmia
What is the treatment for nasal polyps?
Oral and nasal steroids
Immunotherapy and diet
Endoscopic sinus surgery and polypectomy
What is the treatment for an angiofibroma?
Preoperative embolization of blood vessels and lots of blood available
