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otolaryngology > Otalgia > Flashcards

Otalgia Flashcards

1
Q

What is otalgia

A

Ear pain

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2
Q

What does chronic otitis media include (3)

A

Otitis media with effusion, cholesteatoma, perforation

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3
Q

What is otitis externa

A

Inflammation of the outer ear canal

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4
Q

Name 3 bacterial causes for otitis externa

A

Staph aureus
Proteus spp
Pseudomonas

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5
Q

Name 2 fungal causes of otitis externa

A

Aspergillus Niger
Candida albicans

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6
Q

Name some common triggers for otitis externa

A

Water exposure, cotton buds, skin conditions

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7
Q

Clinical presentation of otitis media

A

Redness and swelling of ear canal
Discharge, increased amounts of wax
Buildup can lead to hearing being affected

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8
Q

How do we manage otitis externa

A

TOPICAL
ear drops

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9
Q

What is acute otitis media

A

Inflammation of the middle ear

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10
Q

Who usually gets acute otitis media

A

Infants and children

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11
Q

What is acute otitis media commonly associated with

A

URTIs

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12
Q

Most common bacteria associated with acute otitis media

A

Strep pneumo
H influenzae
Moraxella catarrhalis
Strep pyogenes

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13
Q

How does infection extend in acute otitis media

A

From the throat to the ear via the Eustachian tube

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14
Q

Symptoms of acute otitis media

A

Ear pain, fever, irritability, possibly hearing loss

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15
Q

Clinical signs of acute otitis media

A

Inflammation
Middle ear effusion
Opaque tympanic membrane - bulging may be present
Mobility of tympanic membrane impaired

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16
Q

When can you investigate acute otitis media

A

When the eardrum perforates you can take a swab

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17
Q

Management of acute otitis media

A

80% resolve in 4 days
Amoxicillin or erythromycin if needed

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18
Q

Complications of acute otitis media

A

Subperiosteal abscess
Sensorineural hearing loss
Vertigo
Facial palsy
Brain abscess / meningitis
Venus sinus thrombosis

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19
Q

What is malignant otitis externa

A

Invasive infection of the bone surrounding the ear canal

20
Q

What bones may be affected in malignant otitis externa

A

Mastoid, temporal

21
Q

Most common cause of malignant otitis externa

A

Pseudomonas

22
Q

Risk factors for malignant otitis externa

A

Diabetes, radiotherapy to the head and neck

23
Q

What usually precedes malignant otitis externa

A

Otitis externa

24
Q

Symptoms of malignant otitis externa

A

Pain and headache that is more severe than clinical signs would suggest

25
Q

Clinical signs of malignant otitis externa

A

Granulation tissue at bone-cartilage junction of ear canal
Exposed bone
Facial nerve palsy

26
Q

Investigations for malignant otitis externa

A

Plasma viscosity, CRP
radiological imaging
Biopsy and culture

27
Q

Complication of untreated malignant otitis externa

A

Osteomyelitis progressively involves the skull and meninges
DEATH

28
Q

Management of malignant otitis externa

A

Cleaning and debridement, topical antibiotics of the ear canal
Long term systemic antibiotics
Surgery if necessary

29
Q

Name the 6 Ts of referred pain in the ear

A

Teeth, tonsils, throat, tongue, tumour, trauma

30
Q

What is acute mastoiditis

A

Infection of the mastoid air cells

31
Q

What is acute mastoiditis a complication of

A

Acute otitis media

32
Q

Name 2 common causes of acute mastoiditis

A

Strep pneumo, h. Influenzae

33
Q

Clinical presentation of acute mastoiditis

A

Pain, tenderness and swelling behind the ear

34
Q

Investigation of acute mastoiditis

A

CT, MRI

35
Q

Management of acute mastoiditis

A

IV antibiotics
Some require surgical drainage

36
Q

Complication of acute mastoiditis

A

Mastoid process can get infected, spread to the middle cranial fossa and into the brain causing meningitis

37
Q

What causes referred pain from the auriclo-temporal branch of the mandibular nerve (CN V3) to the ear

A

Lower mandibular pathology: dental
TMJ lesions
Inflammation on the anterior 2/3 of the tongue
Tooth grinding
Salivary gland disease

38
Q

What causes referred pain from the sensory branch of the facial nerve to the ear

A

Geniculate herpes + Ramsay hunt syndrome are related to palsy
Sphenoid or ethmoid sinus pathology
Nasal pathology

39
Q

What causes referred pain from the tympanic branch of the Glossopharyngeal nerve to the ear

A

Tonsillitis or Quincy
Post-tonsillectomy
Carcinoma of the posterior 1/3 of the tongue or tonsils
Neuralgia of the nerve

40
Q

What causes referred pain from the auricular branch of the vagus nerve to the ear

A

Foreign body in piriform fossa
Carcinoma of the piriform fossa, larynx
Piriform abscess
Post-cricoid carcinoma

41
Q

Where does the greater occipital nerve arise from

A

Dorsal rami of C2 and C3

42
Q

Where does the lesser occipital nerve originate from

A

Ventral ramus of C2

43
Q

Where does the greater auricular nerve arise from

A

Ventral rami of C2 and C3

44
Q

What causes referred pain from the greater auricular nerve to the ear

A

Cervical neuritis

45
Q

What causes referred pain from the lesser occipital nerve to the ear

A

Cervical spondylosis
Cervical neuritis
Herpes zoster

otolaryngology (18 decks)

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