OTITIS EXTERNA Flashcards
Otitis Externa
(Acute or Chronic?) inflammation of the
__________ the _____________________.
Acute
skin lining
external auditory canal.
Classifications of Otitis externa
Localized:
__________ e.g _________
__________ e.g __________
Generalized
Circumscribed; Furunculosis
Diffuse ; cellulitis
Classifications of otitis externa
INFECTIOUS
________
_________
_________
Bacterial
Viral
Fungal
Furunculosis
_________ of the ________ commonly by ______________, commonly in the ______________ part of the external auditory meatus.
Inflammation ; hair follicles
staphylococcus aureus
cartilaginous part
AETIOLOGICAL AGENTS of Furunculosis
_______________
Gram negative __________ and _________
Staphylococcus aureus
Pseudomonas
Proteus
Predisposing Factors to Furunculosis
___________
____________ of the ear canal with ________ or ________
Contaminated __________ or ear __________
__________ patient eg Diabetes
Trauma
Scratching ;infected fingers ; sticks
Hearing Aid ; ear mould
Immunocompromised
Clinical features of Furunculosis
_______
Hearing ______
_______
Tragal _______
_______/_______ canal due to furunculosis
Pain; Hearing loss
Discharge; tenderness
Stenosis/swollen
Treatment of Furunculosis
________ pack or ________ and ________
________
________
Glycerin pack or incision and drainage Antibiotics
Analgesics
Otomycosis
AETIOLOGICAL AGENTS
List 5
AETIOLOGICAL AGENTS
Aspergillious Niger
Aspergillious fumigates
Candida Albican
Dermatophytes
Actinomycosis
Symptoms of Otomycosis
__________ within the external canal.
Pain is common with __________ and when there is __________ infection
__________
__________ common in __________
__________ is usually mild
Irritation
Aspergillous flavus ; mixed infection
Hearing loss; Itching
Aspergillious Niger ; Discharge
Signs of Otomycosis
Pinna usually __________
External ear canal may be __________/__________
Tympanic membrane would be ________
Fungal mass may be
Dry whitish/brownish sheet Wet & darkish white Resembling wet blotting paper
Wet & blackish or brownish
normal; congested; ulcerated
intact
Investigations for Otomycosis
________ for _______/_______ & fungal ______
__________ estimate.
Ear swab
culture/sensitivity
smear ; Blood sugar
Treatment of Otomycosis
______________ of fungal mass
_________ of the canal with 2% __________or 1% __________ ____________________ .
Keep ear (dry or wet?).
Treatment of ______________, eg DM.
Aural Washout
Painting ;salicylic acid ; Gentian Violet
antifungal ear drops .
dry ; underlying
Malignant Otitis Externa
(Mild or Severe?) and ___________ infection of the ______________________, involving the ___________ and adjacent ___________ commonly seen in ___________ patient
or ___________ patient.
Severe ; aggressive
external auditory meatus,
temporal bone ; soft tissue
immunocompromised ; diabetic
Malignant Otitis Externa
(Mild or Severe?) and ___________ infection of the ______________________, involving the ___________ and adjacent ___________ commonly seen in ___________ patient
or ___________ patient.
Severe ; aggressive
external auditory meatus,
temporal bone ; soft tissue
immunocompromised ; diabetic
ETIOLOGICAL AGENT of Malignant Otitis Externa
_____________________
Pseudomonas aeruginosa
Presidposing factors to Malignant Otitis Externa
_____________ above ____ years of age. _____________ patients
_____________
_____________ in children
Patient on prolonged _____________
Uncontrolled DM ; 55
Immunocompromised; Malnutrition
Anemia ;steroids.
Pathogenesis of Malignant otitis Media
Infection starts as _________ of ear canal spread (slowly or rapidly?) to the adjacent _________ , _________ and _________.
Infection spread along _________ channels
with _________ & involvement of the ___________________________ cranial nerves.
_______lateral involvement of the _________ and _________ have also been reported.
cellulitis ; ; rapidly ; tissue
suture lines ; skull base.
vascular channels ; osteitis
9th 10th, 11th & 12th
Contralateral ;petrous apex ; basi-sphenoid
Clinical features of malignant otitis externa
_______ (severe)
Discharge – __________in initial stage, __________ and __________ later.
Hearing loss.
_______________.
Tenderness of the __________ or pulling of the __________.
Pain ; mucopurulent
purulent ; blood stained
Facial nerve palsy.
EAC pinna ; mastoids.
OTOSCOPIC EXAMINATION in malignant otitis externa
External auditory canal is (narrow or wide?) .
Granulation tissue in the ____________
TM is ________.
Sings of ________________ in late case.
narrow ; deep meatus
normal ; cranial nerve palsy
Investigations in Malignant Otitis Externa
________
Blood FBC FBS E/U/C
LFT
CT Scan/MRI
_________ bone scan – Increased uptake in the region of skull base.
Ear swab
Isotope
Treatment for Malignant Otitis Externa
___________ / ___________ / Ticarcillin
Maintenance dose is important to prevent _________
Control of DM – Insulin / other anti-diabetic therapy
Surgical treatment – ___________ of the ___________ with removal of ___________.
Excision of ___________.
Gentamycin ; Tobramycin
relapse ; Drainage
sub-periosteal abscess ;necrotic bone.
granulation tissue.
