L2: Ear Infections Flashcards
What is another name for Otitis Externa?
“Swimmer’s Ear”
What is the most common etiology of Otitis Externa (2)?
Most common cause is bacteria - Pseudomonas
- Staph
What type of ear infection involves otalgia worse with manipulation of external ear, and discharge?
Otitis Externa
With which type of ear infection is the TM typically intact?
Otitis Externa
What is the recommended treatment for bacterial Otitis Externa?
Cortisporin Otic or Ciprodex (topical antibiotics)
What is the recommended treatment for a perforated TM with Otitis Externa?
What medication for Otitis Externa should be avoided if there is a perforated TM?
Use Floxin Otic
- Ciprodex should be avoided
What is the recommended treatment for fungal Otitis Externa?
Clotrimazole 1% (topical antifungal)
Are otic suspensions or otic solutions preferred? Why?
Otic suspensions are preferred to solutions due to lower acidity = less tissue irritation
What type of ear infection involves granulation tissue in the external auditory canal (EAC)?
Malignant Otitis Externa
What type of ear infection involves otalgia that is worse at night or with chewing?
Malignant Otitis Externa
What is the etiology of Malignant Otitis Externa? What population is most at risk?
Pseudomonas
- Most at risk: elderly diabetics
If Malignant Otitis Externa is progressing, what neurological problem may be present?
Involvement of CN, specifically CN VII
How do you diagnose Malignant Otitis Externa? What is the recommended treatment?
CT then admission to hospital
- IV Cipro
What type of ear infection involves amber-colored fluid present, but no acute symptoms?
Otitis Media with Effusion (OME/SOM)
What three types of ear infection involve conductive hearing loss?
- Otitis Media with Effusion (OME/SOM)
- Acute Otitis Media (AOM)
- Chronic Otitis Media
What type of ear infection involves negative middle ear pressure?
Eustachian Tube Dysfunction
What is the most common type of Eustachian Tube Dysfunction?
Obstructive dysfunction
How do you diagnose a Eustachian Tube Dysfunction (2)?
- Retracted TM
- Tympanogram Type C
What is the recommended treatment for Eustachian Tube Dysfunction?
Afrin
What type of ear infection involves painful, bulging, erythematous TM with poor mobility?
Acute Otitis Media (AOM)
What is the etiology of Acute Otitis Media (2)?
- Streptococcus pneumoniae
- Haemophilus influenzae
What is the diagnosis for Acute Otitis Media (3 criteria)?
- Moderate/severe TM bulging
- New onset otorrhea not due to acute OE
- Mild bulging AND ear pain for <48 hours or erythematous TM
What is the first line treatment for Acute Otitis Media?
Amoxicillin
What is the second line treatment for Acute Otitis Media?
Augmentin
What should be considered when treating a child with antibiotics for AOM?
Speak with parents… If they don’t want antibiotics, they can observe/follow up in 2-3 days – if treatment fails (symptoms persist/worsen), start or try another antibiotic
What constitutes a diagnosis of recurrent AOM?
Symptoms return within 30 days after completion of successful treatment
How should recurrent AOM be treated if it has been less than 15 days since previous AOM diagnosis? How should it be treated if it has been more than 15 days?
- IM Rocephin if <15 days
- Augmentin if >15 days
When should T-tubes be considered as treatment (2 reasons)?
- 3 or more episodes of AOM in 6 months
- 4 or more episodes of AOM in 12 months
What are the seven complications associated with AOM? (sorry this card sucks but didn’t know how else to ask…)
- Conductive hearing loss from persistent MEE (middle ear effusion)
- TM perforation
- Chronic OM
- Tympanosclerosis
- Cholesteatoma
- Mastoiditis
- Acute Labyrinthitis
What complication of AOM involves scarring, white plaques in TM?
Tympanosclerosis
What complication of AOM involves abnormal growth of squamous epithelium in the middle/ear? What is the treatment?
Cholesteatoma
- Treatment: surgery
What complication of AOM involves post-auricular pain, edema and erythema?
Mastoiditis
What are the recommended treatments for Mastoiditis (2)?
- IV antibiotics
- Mastoidectomy
What is Acute Labyrinthitis a result of?
Viral or post-viral inflammatory disorder
What type of complication of AOM involves acute onset of severe vertigo with N/V, unilateral hearing loss?
Acute Labyrinthitis
What test will be positive for a diagnosis of Acute Labyrinthitis? Describe what this looks like if positive…
Head Thrust: cannot maintain visual fixation when head turned to affected side
What is the recommended treatment for Acute Labyrinthitis?
Symptomatic treatment with Meclizine or Benzos
What type of ear infection involves painless TM perforation and otorrhea? How long should the otorrhea be present?
Chronic Otitis Media
- Otorrhea for >2 weeks
What is the most common etiology of Chronic Otitis Media (2)?
- Pseudomonas
- S. aureus
What is a common etiology of Otitis Media with Effusion (OME) - hint: not bacteria or virus?
Recent AOM
What type of ear infection involves a Tympanogram B pattern? What does this mean/indicate?
Otitis Media with Effusion (OME)
- Tympanogram B: little/no mobility (i.e. fluid or TM perforation present)
What type of ear infection involves a Tympanogram C pattern? What does this mean?
Eustachian Tube Dysfunction
- Tympanogram C: retracted
What type of ear infection often involves mastoid air cells (mastoiditis)?
Acute Otitis Media (AOM)
