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Year Two - Ears, Nose & Throat > Otitis Externa > Flashcards

Otitis Externa Flashcards

1
Q

What is otitis externa?

A

It is defined as condition in which there is inflammation of the external ear canal

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2
Q

What are the two classifications of otitis externa?

A

Acute Otitis Externa

Chronic Otitis Externa

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3
Q

What is acute otitis externa?

A

It is defined as inflammation of the external ear canal which persists for a period less than three weeks

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4
Q

What is chronic otitis externa?

A

It is defined as inflammation of the external ear canal which persists for a period greater than three weeks

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5
Q

What are the seven risk factors asscoiated with otitis externa?

A

Bacterial Infection

Fungal Infection

Seborrhoeic Dermatitis

Contact Dermatitis

Psoriasis

Acne Vulgaris

Swimming

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6
Q

What two bacterial infections are associated with otitis externa?

A

Psuedomonas Aeruginosa

Staphylococcus Aureus

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7
Q

What two fungal infections are associated with otitis externa?

A

Candida Albicans

Aspergillus Niger

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8
Q

What are the six clinical features associated with otitis externa?

A

Ear Pain

Watery Ear Discharge

Ear Itch

Ear Erythema

Conductive Hearing Loss

Auricular Lymphadenopathy

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9
Q

Describe the ear pain associated with otitis externa

A

The pain stimulated on palpation of the tragus

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10
Q

What two investigations are used to diagnose otitis externa?

A

Hearing Tests

Ear Swab Microbiology

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11
Q

What two hearing test results indicate otitis externa?

A

Negative Rinne’s Test, BC > AC

Weber’s Test Lateralises To Affected Ear

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12
Q

When is ear swab microbiology used to investigate otitis externa?

A

When pharmacological management is deemed ineffective following a maximum 14 day course

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13
Q

What are the two conservative management options of otitis externa?

A

Strict Water Precautions

Avoid Cotton Bud Use

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14
Q

What are the two pharmacological management options of otitis externa?

A

Topical Antibiotics ± Topical Steroids

Oral Antibiotics

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15
Q

When are topical antibiotics ± topical steroids used to manage otitis externa?

A

They are the first line management option

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16
Q

Name a topical antibiotic + topical steroid used to manage otitis externa

A

Otomise Spray (Neomycin + Dexamethasone)

17
Q

What course length of topical antibiotics ± topical steroids is used to manage otitis externa?

A

7 - 14 days

18
Q

What topical antibiotic class should be avoided in cases where the tympanic membrane is perforated? Why? What anitbiotic should be instead administered?

A

Aminoglycosides

This is due to the risk of ototoxicity

Quinolone

19
Q

When are oral antibitoics used to manage otitis externa?

A

They are the second line management option of otitis externa, in cases where infection extends beyond the external ear canal

20
Q

Name an oral anitbiotic used to manage otitis externa

A

Flucloxacillin

21
Q

In which patient group, are oral antibiotics recommended as the first line management option? Why? Which antibitoic is administered?

A

Diabetics

This is due to the fact that in diabetic patients pseudomonas auergonisa is a common causative organism

Oral ciprofloxacin

22
Q

When should otitis externa be urgently referred to ENT? Why?

A

When pharmacological management is deemed ineffective following a maximum 14 day course with worsening pain

This indicates malignant otitis externa

23
Q

What complication is associated with otitis externa?

A

Malignant Otitis Externa

24
Q

What is another term for malignant otitis externa?

A

Necrotising otitis externa

25
Q

What is malignant otitis externa?

A

It is defined as an external ear canal infection which extends beyond soft tissues, resulting in osteomyelitis of the temporal bone and skull base

26
Q

What bacterial infection is assoicated with malignant otitis externa?

A

Psuedomonas Aeruginosa

27
Q

What are the four risk factors associated with malignant otitis externa?

A

Older Age > 65 Years Old

Diabetes Mellitus

Immunosuppression

Recurrent Otitis Externa

28
Q

What are the six clinical features of malignant otitis externa?

A

Non-Resolving Otitis Externa

Severe Otalgia

Purulent Otorrhea

Temporal Headaches

Facial Nerve Palsy

Ear Canal Granulation Tissue

29
Q

What investigation is used to diagnose malignant otitis externa?

A

CT Scans

30
Q

What is a feature of malignant otitis externa on CT scans?

A

The presence of bony erosions within the external ear canal

31
Q

What are the two management options of malignant otitis externa?

A

Urgent Referral To ENT

IV Ciprofloxacin

32
Q

Why do we administer IV ciprofloxacin to manage malignant otitis externa?

A

This antibiotic covers pseudomonas auerginosa infection, which is most commonly associated with malignant otitis externa

Year Two - Ears, Nose & Throat (12 decks)

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