Lecture 10 - Anatomy + Ear Conditions Flashcards
What is infection of the pinna called?
Perichondritis
What is the problem with perichonditis of the pinna?
Since its made of cartilage its heals poorly
What is the name of the condition where theres unilateral facial drooping and vesicles in the ear/pinna?
So a facial nerve palsy with red ear vesicles
Ramsay Hunt syndrome
What is Ramsay-Hunt syndrome?
When theres a facial nerve palsy leading to unilateral facial droop and there’s red ear vesicle
What is the stage that occurs before cauliflower ear?
Pinna haemotoma
What is a Pinna haemotoma?
When blood accumulates between teh cartilage of the pinna and the overlying perichondrium
What is perchondrium?
The layer that sits on top of cartilage
What is the pathology of a Pinna Haematoma?
Blunt trauma leads to shearing of perichondrium from the cartilage
Cartilage relies on the perichondrium for its blood supply
Leads to its necrosis
Also pressure necrosis from the build up of blood between the cartilage and perichondrium
How does a pinna haemotoma lead to cauliflower deformity if left untreated?
The necrosis/ischaemic damage to the cartilage leads to fibrosis/repair of the cartilage in an uncontrolled
How is pinna Haematoma treated preventing cauliflower deformity?
Drain ear
Prevent the reaccumlation of fluid by bringing the 2 layers (cartilage and perichondrium)
Go to the last slide, what is the condition in picture 1?
This is the external acoustic meatus, its been narrowed since its inflammed
Otitis externa (due to infection)
What is the normal cause of inflammation of the External Acoustic Meatus?
Infection
What are the 2 main bacterial infections that cause Acute Otitis Externa?
Staphylococcus aureus
Pseudomonas aeruginosa
What are the symptoms of Acute Otitis Externa?
Otalgia
Custard like discharge
Can have hearing loss depending on extent of inflammation
What are some risk factors for Acute Otitis Externa?
Injury to External acoustic meatus like itching
Swimming/warm weather
Skin problems like eczema
How is Acute Otitis Externa treated?
Ear drops (topical antibiotic)
+
Steroid depending on how inflammed it is
What is a potentially life threatening complication of Otitis Externa?
Necrotising Otitis Externa
What is Necrotising Otitis Externa?
Where the infection from otitis externa spreads to the the ossicles, temporal bone and skull base (OSTEOMYELITIS)
What are the symptoms of Necrotising Otitis Externa?
Severe Otalgia (CANT SLEEP)
Hearing loss
Can get Cranial nerve symptoms
What are the risk factors for Necrotising Otitis Externa?
Old
Male
Immunocomprimised
Diabetic
What investigations are often done if suspecting Necrotising Otitis Externa?
CT temporal bone to see how far osteomyelitis spread
How is Necrotising Otitis Externa treated?
IV antibiotics
Can be oral sometimes with ear drops
Lots of analgesia
What is a very common infection of the middle ear in children?
Acute otitis media
Why is Acute otitis media common in babies and young children to 4yrs?
Short Eustachian/pharyngotympanic tube which opens to large adenoids (bigger in young children)
What are some symptoms of Acute Otitis media (middle ear infection)?
Otalgia
Fever
Can have red tympanic membrane
Can have non specific signs in infants like pulling on ear
What is the treatment of Acute Otitis Media?
Usually resolves in 3 - 1week
Analgesia
Back up Abx prescription if doesn’t resolve
What are some potential complications of Acute Otitis Media (middle ear infection)?
Tympanic membrane perforation
Facial nerve involvement
Life threatening:
Mastoiditis
Meningitis
Sigmoid sinus thrombosis
Brain abscess (posterior cranial fossa)
How does Mastoiditis present?
Signs + symptoms of Acute Otitis Media
Unwell + pyrexia
Oedema around mastoid
No longer sharp angle behind ear (sticks out)
Pinna pushed down and forward
What is Otitis media with effusion/Glue ear?
NOT AN INFECTION
Where inflammatory fluid accumulates in the middle ear which affects the hearing