Otalgia Flashcards
What is otalgia?
Earache
What are some causes of otalgia arising from the pinna and ear canal?
- Otitis externa
- Malignant otitis externa
- Infection (E.g. folliculitis, cellulitis, perichondritis, candida, Herpes-zoster, HSV)
- Sebaceous cyst
- Squamous cell carcinoma of ear canal
- Trauma with cleaning techniques
What is otitis external?
Inflammation of the outer ear canal
What are some causes of otitis external?
Infection (Most common)
Inflammation in response to shampoo or ear drops
What are some bacterial causes of otitis external?
Staph. aureus
Proteus spp.
Pseudomonas aeruginosa
What are some fungal causes of otitis external?
Aspergillus niger
Candida albicans
What are some common triggers of otitis external?
Water exposure
Cotton buds
Skin conditions
What are some symptoms of otitis externa?
- Redness and swelling
- Possibly itchy (In early stages)
- Otalgia
- Discharge or increased wax
- Possible hearing loss if blocked by swelling or secretions
What condition is shown?
Otitis externa
What management options are available in otitis external?
General advice
Topical aural toilet
Antimicrobials if unresponsive
Systemic antibiotics if severe (E.g. cellulitis)
What topical antimicrobial is used in bacterial otitis media?
Gentamicin
What topical antimicrobial is used in fungal otitis media?
Clotrimazole
What are some pieces of general advice given to patients with otitis externa?
- Keep water out of the ear
- Avoid traumatising with e.g. cotton buds
- Keep hearing aids out as much as possible
What management option is there for eczematous otitis externa?
Steroid with no antibiotic (Antibiotic may cause local sensitivity)
How are antibiotics applied in cases where the external ear canal is very oedematous and swollen?
A wick or dressing may be used to carry the drops past the swollen skin
What are the most common tumours found within the ear canal?
SCCs and BCCs of the pinna or ear canal
What are some other tumours found within the ear?
- Ceruminous adenoma
- Ceruminous adenocarcinoma
- Meningioma
- Middle ear adenoma
- Aggressive papillary tumour
- Vestibular schwannoma (Acoustic neuroma)
How will SCCs of the ear present?
- Firm, red nodules and sores on skin of the ear
- Discomfort in the affected ear
- Hearing problems
- Tinnitus
- Vertigo
What are some causes of otalgia arising from the tympanic membrane?
- Barotrauma
- Myringitis (Ramsay Hunt syndrome, Myringitis bullosa)
- Inflammation secondary to otitis media
What are some causes of otalgia arising from the middle ear?
- Cholesteatoma
- Otitis media
- Otitis media with effusion (OME)
- Malignant otitis
What is malignant otitis externa?
Invasive infection of the bone surrounding the ear canal (i.e. the mastoid and temporal bones)
What is the most common cause of malignant otitis externa?
Pseudomonas aeruginosa
What are some risk factors for developing malignant otitis externa?
Diabetes
Radiotherapy to the head and neck
What are some symptoms of malignant otitis externa?
Pain and headache, more severe than clinical signs would suggest