Otalgia Flashcards

1
Q

name 5 causes of ear pain

A
  • acute otitis externa
  • malignant otitis externa
  • acute mastoiditis
  • acute suppurative otitis media
  • otitis media with effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

name 5 causes of otorrhoea/discharge

A
  • acute suppurative otitis media
  • chronic suppurative otitis media
  • chronic otitis externa
  • CSF following head injury
  • acute coalescent mastoiditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

3 types of Otitis externa

A
  • acute
  • chronic
  • malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute otitis externa is …

A

diffuse inflammation of the external ear canal, which may also involve the pinna + tympanic membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Presentation of AOE

A
  • otalgia
  • pain on moving the pinna
  • otorrhoea
  • conductive hearing loss
  • itchy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Patient with AOE may have a history of ____

A

swimming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ear canal in acute AOE is …

A

oedematous + tender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

potential causes of AOE?

A
  • previous ear surgery
  • topical treatments
  • trauma to ear canal (e.g. from cleaning)
  • use of hearing aids/ear plugs
  • exposure to warm climate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

condition that is a risk factor for AOE?

A

diabetes mellitus + immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is AEO diagnosed?

A

Presence fo symptoms of rapid onset (within 24 hours) within past 3 weeks
+
signs of ear canal inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

usual organism for AOE (2)

A
  • Pseudomonas Aeruginosa

- Staphylococcus Aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

management of AOE?

A

topical abx w/ or w/o/ steroids

minimum of 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what abx should you not give if there is tympanic membrane perforation, and why?

A

Aminoglycosides

risk of ototoxicty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

3 complications of AOE?

A
  • facial cellulitis
  • otomycosis
  • malignant otitis externa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is Otomycosis and what causes it?

A

fungal ear infection, of the external auditory canal

well known complication of long term treatment with antibacterial agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Late complication of Otomycosis

A

Canal stenosis with hearing loss

17
Q

what is the risk of diabetics + immunocompromised individuals with Malignant otitis externa?

A

They are assumed to have osteomyelitis of the temporal bone if symptoms do not settle within 2 weeks

18
Q

who is at risk of Malignant otitis externa

A

Diabetes or immunosuppressed

19
Q

where does the infection begin and progress to in malignant otitis externa?

A

begins in the soft tissue of the external auditory meatus –> progresses to into the bony ear canal, can progress to temporal bone osteomyelitis

20
Q

CT findings in Malignant otitis Externa

A

Soft tissue + bone destruction, granulation tissue in the ear canal

21
Q

clinical features in Malignant Otitis Externa

A
  • otalgia
  • purulent otorrhoea
  • aural fullness
  • not responding to conventional treatment for AOE
22
Q

what can malignant otitis externa cause by affecting the middle ear

A

sensorineural hearing loss

23
Q

management of Malignant otitis externa

A

IV Gentamicin or Ciprofloxacin

24
Q

most common causative organism in Malignant otitis externa

A

Pseudomonas Aeruginosa

25
Q

Chronic otitis Externa is caused by…

A

chronic combined infection of fungal + staphylococcal

26
Q

clinical features of COE

A

chronic discharge accompanied by itching + irritation

27
Q

describe the discharge in COE

A

chronic, thick, smelly

28
Q

signs of fungal infection in COE?

A
  • white cotton like strands of candida
    OR
  • small black/white balls of Aspergillus
29
Q

symptoms in COE? (3)

A
  • hearing loss
  • discharge
  • itching
30
Q

cause of COE?

A
  • skin disease: eczema, psoriasis

- external trauma to the ear: wetting, drying, scratching

31
Q

Management of COE?

A
  • cleanse external ear
  • antibacterial + antifungal ear drops
  • cleaning: remove infected debris
  • aural toilet: cleaning external auditory meatus
  • microbial swabs for bacteria + fungus