Otic Flashcards
7What is the name for the entire external ear?
pinna
What is the name of the small protective cartilage in front of the ear canal?
tragus
What happens to earwax as you age?
earwax gets drier and stickier
What accounts for the most cases of conductive hearing loss in older adults?
earwax buildup
What is the most common cause of earwax impactions?
Q-tips
How do ear syringes work?
2soften wax first (few drops of oil BID x 2-3 days)
put warm water in them and flush out ear
-aim towards top of ear canal
What are the ingredients in Cerumol?
peanut oil (doing all the work)
paradichlorobenzene
chlorbutol
oil of terebinth
What is the youngest age on the package of Cerumol?
> 12yrs
How do you use Cerumol?
lie or sit down and tilt your head to the side
put 5 drops into the ear canal
plug ear with a cotton ball moistened with Cerumol but do not push it into ear canal to help keep liquid in the ear canal
remove cotton ball after one hour or next morning
repeat 2-3x a day for 3 days
chewing action at TMJ can help move earwax outward
What is the working ingredient in Murine?
carbamide peroxide (a bit more dissolving)
How do you use Murine?
tilt head sideways and place 5-10 drops in ear canal
keep drops in ear for several minutes by keeping head tilted forward or placing cotton in ear
use BID for up to 4 days if needed
any wax remaining after treatment may be removed by gently flushing the ear with warm water
What is the youngest age on the package of Murine?
> 12yrs
What is the working ingredient in Earol?
olive oil
more expensive than Murine and Cerumol
What does Salinex Earigate claim to do?
get behind wax plug and shoot it back out (reverse flush)
-likely pushes earwax further
How is Earigate used?
tilt head
insert device into ear
activate nozzle
solution will wash wax out of ear
need to soften the wax first
When do we refer for a case of earwax?
foreign body in ear
pain
dizziness
tinnitus
treatment failure
What are some things to keep in mind during an earwax counsel?
could it be an infection? (pain in ear)
constant ringing in ear=tinnitus
dizziness (could be due to lots of things)
What is tinnitus?
ringing in ears
What are common causes of tinnitus?
excessive or cumulative noise exposure
foreign body or earwax
head and neck injuries
ear infections
What is the cure for tinnitus?
no cure
but there are ways to manage it
True or false: EarTone is great for tinnitus
false
if it worked it was placebo
What is vertigo?
feeling that environment is spinning
-disconnect that basically causes bad motion sickness
-form of dizziness
What causes vertigo?
problems in brain or inner ear
viral or bacterial inner ear infections
Menieres disease
What are the symptoms of vertigo?
sensation of disorientation
maybe nausea or vomiting or hearing loss
What are some drugs commonly tried for vertigo?
Serc (betahistine)
-H1 receptor agonist, H3 receptor antagonist
meclizine
both of questionable value
True or false: the middle ear is located in front of the eardrum
false
located behind the eardrum
How do bacteria or viruses enter the middle ear?
through the Eustachian tube
common after an URTI
What are ear tubes?
small tubes put through the eardrum
-they let fluid drain out of the middle ear and stop it from
building up
-usually stay in for 8-18 months and fall out on their own
-for kids who get lots of ear infections
What might a kid with tympanostomy tubes need for swimming?
earplugs
What is otitis externa?
inflammation of the outer ear and ear canal
What is a common diagnostic of otitis externa in physical examination?
pulling the tragus causes pain
swollen ear canal and itchy
summer season
discharge
What are causes of otitis externa?
staying in pool water too long (allows microbes to settle in)
chlorine in pool (changes ear conditions from acidic to alkaline which is better host for microbes)
Q-tips
What are the most common organisms to cause otitis externa?
Pseudomonas aeruginosa
Candida albicans
What are some Rx options for otitis externa?
Ciprodex (ciprofloxacin + dexamethasone)
Locacorten Vioform (flumethasone + pivalate + clioquinol)
What is a non-pharm option to treat or prevent otitis externa?
acidifying agents:
-half rubbing alcohol and half vinegar
-vinegar with equal parts warm water
symptoms should be better in 3 days
these are just as good as topical antibiotics
What is AuroDri?
a drying agent rather than actual treatment for swimmers ear
-isopropyl alcohol 95%, glycerin 5%
-apply 4-5 drops in affected ear after swim
-helps relieve water-clogged ears after swimming
What can someone use to prevent swimmers ear if they dont want to use drops?
earplugs
What is the treatment for seborrhea of the ear canal?
selenium 1% shampoo
zinc pyrithione shampoo
ketoconazole shampoo
Rx anti-fungal creams (ciclopirox and ketoconazole)
not tar
use twice weekly if shampoo, if cream BID in ear canal
What do we do for a boil in the ear canal?
leave it be, dont squeeze it
will go away in a week or so
What are non-pharm things that can be done to equalize ear pressure?
swallow reflex (Toynbee maneuvre)/gum chewing
hold nose, then equalize with pressure (Valsalva maneuvre)
When is ear pressure the worst during a flight?
descent
What is a drug option to prevent barotrauma?
oral decongestants
-not topical
-take 30 minutes prior to takeoff
How long does it take for a perforated eardrum to heal?
6-8wks
sharp pain when an eardrum is peforated
What are common causes of earaches?
ear infection
changes in air pressure
earwax buildup
less common is TMJ syndrome
What are the active ingredients in Auralgan?
benzocaine (anesthetic to numb pain)
antipyrine (analgesic that helps decrease pain and swelling)
True or false: Auralgan is great for swimmers ear and ear boils
false
How is Auralgan used?
can repeat several times a day
has been discontinued
What are the ingredients in Polysporin Ear Drops?
polymyxin (gram - )
lidocaine
more acidic
back pocket option for otitis externa if MD unavailable
