otalgia Flashcards
what are the causes of ear pain originating from the ear ?
auricular hematoma
perichondritis
otitis externa
malignant otitis exteerna
acute otitis media
otitis barotrauma
bullous myringitis
what is the most common cause of referred otalgia ?
TMJ arthiritis
followed by cervical vertebrae problems
what is the presentation of an auricular hematoma ?
painful smooth bluish custic swelling of the ear
how does an auricular hematoma form ?
usually due to blunt trauma, where a colleection of blood exists between the cartilage and perichondrium
what is the treatment for Auricular hematomas ?
aspiration and bandage if a cyst has been formed
evacuation of blood if organized
what are the complications associated with auricular hematoma ?
if not treated may lead to perichondritis and severe deformity of the ear ( cauliflower ear)
what is perichondritiis ?
inflammation of the auricular cartilage and its peerichondrium
what are the causes of perichondritis ?
infected hematoma
auricular laceration
furunculosis
burns
what is the presentation of perichondritis ?
red hot painful tender auricle
what is thee treatment for perichondritis ?
systemic and local antibiotics
analgesics
surgical debridement of necrosed cartilage may be required
what are the complications of perichondritis ?
fibrosis and severe deformity of the auricle ( cauliflower ear)
what is the presentation of otitis externa ?
otalgia
tenderness on tragus or pulling of auricle
meatus narrowing
discharge
what is malignant otitis externa ?
osteomyelitis of the lateral skull bone
what is the presentation of malignant otitis externa ?
deep seated ear pain that worsens inn the night
in a diabetic or immunocompromised patient
hasn’t been responding to treatment of otitis externa for 2 weeks
granulations may be seen on the floor of the EAC
what is the presentation of acute otitis media ?
usually in a child
fever
severe otalgia
may be preceded by URTI
injected or bulging TM
what is the presentation of otitis barotrauma ?
history of upper respiratory tract infection
history of flight or diving
earache, fullness, hearing loss, tinnitus
what is seen on otoscopy in cases of otitic barotrauma ?
retracted congested TM
may be middle ear effusion or haemotympanum
what is the prophylactic treatment for otitic barotrauma ?
avoid flying or diving with common cold
avoid sleeping during descent
chewing gum, valsalva maneuver
nasal decongestant drops
what is the curative treatment for otitic barotrauma ?
nasal decongestant
valsalva maneuver
in severe cases myringotomy may be needed
what are the causees of bullous myringitis ?
viral or bacterial
what are the most common causative organisms in bullous myringitis ?
RSV
strep pneeumonia
what is seen on otoscopy of bullous myringitis ?
clear or reddish bullae/vesicles
congested tympanic membrane
rupture of the bullae results in decreased levels of the pain
may be associated with bloody otorrhea
what is the treatment for bullous myringitis ?
systemic antibiotics or analgesics
what is the presentation of TMJ arthiritis ?
normal otoscopy
tenderness oveer TMJ
may also present with dental problems
malocclusions
bruxism
what is the most common cause of ottalgia originating from the ear ?
otitis externa
what is the most common cranial neuralgia linked to otalgia ?
trigeminal neuralgia
ddx of a patient with history of URTI and otalgia ?
acute otitis media
otitic barotrauma
what are the ddx of a patient with a retracted TM ?
inactive squamous chronic otitis media
otitic barotrauma
glue ear - otitis media with effusion
what is the commonest cause of otalgia originating from the ear ?
otitis externa
what is the commonest cause of referred otalgia in the ear ?
TMJ arthiritis
what are the red flags associated with otalgia ?
pharyngeal or laryngeal symptoms
