Maxillofacial Infections (ludwigs angina, otitis, sinusitis, mastoiditis), Acute Vestibular Dysfunction (labrinthitis, menieres disease), Maxillofacial Trauma

Question 1

infxn of the ear canal causing pain, redness and swelling of ear canal and possibly the pinna and tragus

pinna worked w/ chewing or movement of pinna/tragus

patient may have unilateral hearing loss (d/t edema of canal) and purulent drainage from the ear

tx - analgesics, topical/otic abx and steroids

teaching - warm ear drops prior to administration (to decrease dizziness), heating pad/warm compress to ear, keep canal dry, leave earwick in place until it falls outs (2-3 days)

Answer 1

otitis externa (Swimmers ear)

Question 2

infxn of the middle ear that is most common before the age of 5 causing ear pain (preverbal children may rub or pull on ears), h/a, tinnitus, hearing loss and n/v,

if tympanic membrane ruptures - otorrhea may be present

tx - IV abx, drainage of middle ear (myringotomy)

Answer 2

otitis media

Question 3

infxn of mastoid bone nearly always as a complication of undertreated otitis media

most common in children <2

causes redness, edema and tenderness behind the ear

complications may include facial nerve palsy, meningitis, venous sinus thrombosis and osteomyelitis

tx - systemic abx, analgesics

teaching - keep ear Canal dry if tympanic membrane ruptured

Answer 3

mastoiditis