Otitis externa Flashcards
what is otitis externa ?
inflammation of the external auditory canal
what are the risk factors associated with otitis externa ?
swimming
warm and humid climates
underlying skin conditions like eczema
immunosuppression
trauma
hearing aids
what are the causative oganisms
of otitis externa ?
mostly bacteria : pseudomonas aeruginosa and Staph Aureus
can also be fungal after prolonged antibiotic use
what aree the symptoms associated with otitis externa ?
otalgia - especially on movement of the pinna or the jaw
itching
discharge
hearing loss
what is the first symptom associated with each of :
bacterial otitis externa
fungal otitis externa ?
bacterial otitis : first complaint is pain
fungal otitis: first complaint is itching
what are the signs associated with otitis exteerna ?
tenderness on the tragus or pulling of the auricle
swelling of the external auditory meatus
eryhtema
purulent discharge
what investigations should be done for otitis externa ?
swab from thee EAC for culture and sensitivity
whatt is the treatment for otitis externa ?
aural toilet by suction
topical antibiotic
or topical anti-fungal
ear packing in case of severe oedema ( feteel el othon)
what is malignant otitis externa ?
severely painful progressive otitis externa
not responsive to medical treatment
for more than 2 weeks
history of diabetes or uncompromised 3amatan
what is the etiology associated with malignant otitis externa ?
osteomyelitis of the lateral skull base
what is the main complication associated with Malignant otitis exteerna ?
multiple lower cranial nerve palsies ( lower facial nerve palsy)
what are the signs associated with malignant otitis externa ?
deep seated pain that worsens at night
swelling of the EAC
erythema
purulent discharge
granulation seen at the floor of the EAC
what are the investigations required for malignant otitis externa ?
swab for sensitivity and culture
blood glucose and ESR
CT scan is required
biopsy from granulationn to exclude malignancy
what is the treeattment of malignant otitis externa ?
hospitilization first
control of blood sugar
IV Ab
regular aural toilet
surgical debridement may be required
what is ramsay hunt syndrome characterized by ?
Herpes Zoster Oticus
characterized by severly painful vesicular exanthem
7th and 8th cranial nerve may bee affected
what are the diagnostic features of ramsay hunt ?
facial paralysis
SNHL
vesicular exanthem
what is otomycosis ?
fungal ear infection
if on examination of a suspected otitis externa patient a perforated TM is found what is this likely an indication of ?
chronic suppurative otitis media and the otitis externa happened as a secondary complication
otalgia that increases at night is indicative of ?
malignant otitis externa
what is the causative organism in Ramsay Hunt syndrome ?
varicella zoster virus
what are the complications of ramsay hunt syndrome ?
affection of the 7th and 8th cranial nerve
facial nerve paralysis
SNHL
post herpetic neuralgia
what is thee treatment for Ramsay Hunt syndrome ?
systemic steroids
systemic antivirals
analgesics
