Otitis Externa Flashcards
Definition of otitis externa
Diffuse inflammation of the skin and subdermis of the external ear canal. Can involve the pinna.
What classifies as acute and chronic otitis externa
acute - inflammation of less than 6 weeks
chronic - inflammation lasting longer than 6 months
Causative organisms of acute and chronic otitis externa
acute - bacterial, mainly pseudomonas aeruginosa or staphylococcus aureus
chronic - aspergillus species or candida albicans
Risk Factors for acute OE - 5
skin conditions such as eczema, psoriasis
AOM
contact dermatitis
trauma
water exposure
Risk factors for chronic otitis externa - 4
Skin conditions
uncontrolled DM
immunocompromisation
fungal infection
Name the 3 types of otitis externa
Acute OE
Chronic OE
Malignant OE - progressive infection of external ear which causes osteomyelitis of the temporal bone. Can be life threatening
Investigation of otitis externa
mainly clinical diagnosis from examination and history
Presentation of otitis externa - 8
Pain on pinna, tragus or jaw
Ear discharge
Itching in ear canal
Fever
Hearing loss
Examination:
- red oedematous ear canal
- regional lymphadenopathy
- perforation of the tympanic membrane
Management of Acute otitis externa - 5
- keep ear clean and dry
- manage skin conditions if they have them
- simple analgesia
1st line - topical antibiotics and topical corticosteroids
2nd line - oral antibiotics
Management of Chronic otitis externa - 5
- manage underlying cause
- simple analgesia
- aural cleaning
- topical antifungal prep e.g. clotrimazole 1%
- topical corticosteroids.
Complications otitis externa - 3
Regional spread of infection causing cellulitis, abscess
fibrosis of ear cancal
malignant OE
Differentials otitis externa - 7
AOM
Forign body in ear
impacted ear wax
skin conditions
Cholesteatoma
Mastoiditis
Referred pain
