Otitis Externa

Question 1

Define otitits externa

Answer 1

diffuse inflammation of external ear canal

Question 2

most common causes of otits externa (2)

Answer 2

Pseudomonas aeruginosa

Staph A

Question 3

What is needed for otits externa diagnosis

Answer 3

prescen of rapid onset (<48hr) of symptoms within past 3 weeks coupled with signs of ear canal inflammation

Question 4

who is primarly affected by otitis externa

Answer 4

children 7-12yo

Question 5

causes for otitis externa 4

Answer 5

pseudomonas aeruginosa

staph A

-98% CAUSED BY BACTERIA

idiopathic

trauma

Question 6

Classifications of otitis exertna 5

Answer 6

localised- hair follicles in cartilaginous protion of exernal audiatory canal

diffuse- infection limiited to skin of EAC and concha

Part of a gerneralised skin condtion ie seborrheic dermatis, allergic dermatitis, atotpic dermatitis or psoriassi

invasive- necrosis of adjacent cartilage or bone of EAC

hyperekratosis of EAC-> corrosion of canal bone

Question 7

symptoms of ear canal inflammation 4

Answer 7

pain

itching

fullness

decreased hearing

Question 8

signs of ear canal inflammation 5

Answer 8

tenderness over tragus, pinna or both

manipulation of ear canal painful

skin of EAC has oedema, erythema or swelling

otorrhoea

tympanic membrane erythematous

Question 9

risk fcators for otitis ecterna 8

Answer 9

EAC obsturction

high environmental humititdy

swimming

local trauma

alllergy

skin disease

diabetes

immunocompromsied

Question 10

investigations for otitis external 5

Answer 10

pneumatic otoscopy

tympanometry

ear culture

microscopy of exudate/debris

CT/MRI

Question 11

diiferentals for otitis externa 3

Answer 11

acute otits media

furuculosis

contact dermatitis of ear canal

Question 12

1st line managemnt of otits externa - bacterial 3

Answer 12

antibacterial otic drops -ciprofloxaisin/dexamethasone otic
+
Pain management (PCM/ibu)

Question 13

define necrotizing (malignant otits externa), who gets it and what it can lead to

Answer 13

n aggressive, life-threatening infection of the external ear that can lead to temporal bone destruction and base-of-skull osteomyelitis. 90% have diabetes

Question 14

2nd line otitis externa maangemnt 3

Answer 14

oral ABx- ciprofloxacin or amox
+ drops
+pain management

Question 15

otitis media w malignant or necrotising 3

Answer 15

1st + 2nd line + debridement + hyperbaric O2 + IV ABx

Question 16

complications of otitis media 3

Answer 16

contact dermatitis or other chemical related sweling

crainial nerve palsy

osteomyelitis of skull base