OTITIS EXTERNA

Question 1

Otitis Externa

(Acute or Chronic?) inflammation of the
__________ the _____________________.

Answer 1

Acute

skin lining

external auditory canal.

Question 2

Classifications of Otitis externa

Localized:
__________ e.g _________
__________ e.g __________

Generalized

Answer 2

Circumscribed; Furunculosis

Diffuse ; cellulitis

Question 3

Classifications of otitis externa

INFECTIOUS
________
_________
_________

Answer 3

Bacterial

Viral

Fungal

Question 4

Furunculosis

_________ of the ________ commonly by ______________, commonly in the ______________ part of the external auditory meatus.

Answer 4

Inflammation ; hair follicles

staphylococcus aureus

cartilaginous part

Question 5

AETIOLOGICAL AGENTS of Furunculosis

_______________
Gram negative __________ and _________

Answer 5

Staphylococcus aureus

Pseudomonas

Proteus

Question 6

Predisposing Factors to Furunculosis

___________
____________ of the ear canal with ________ or ________
Contaminated __________ or ear __________
__________ patient eg Diabetes

Answer 6

Trauma

Scratching ;infected fingers ; sticks

Hearing Aid ; ear mould

Immunocompromised

Question 7

Clinical features of Furunculosis

_______
Hearing ______
_______
Tragal _______
_______/_______ canal due to furunculosis

Answer 7

Pain; Hearing loss

Discharge; tenderness

Stenosis/swollen

Question 8

Treatment of Furunculosis

________ pack or ________ and ________

________

________

Answer 8

Glycerin pack or incision and drainage Antibiotics
Analgesics

Question 9

Otomycosis

AETIOLOGICAL AGENTS
List 5

Answer 9

AETIOLOGICAL AGENTS
Aspergillious Niger
Aspergillious fumigates
Candida Albican
Dermatophytes
Actinomycosis

Question 10

Symptoms of Otomycosis

__________ within the external canal.
Pain is common with __________ and when there is __________ infection
__________
__________ common in __________
__________ is usually mild

Answer 10

Irritation

Aspergillous flavus ; mixed infection

Hearing loss; Itching

Aspergillious Niger ; Discharge

Question 11

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

Answer 11

normal; congested; ulcerated

intact

Question 12

Investigations for Otomycosis

________ for _______/_______ & fungal ______

__________ estimate.

Answer 12

Ear swab

culture/sensitivity

smear ; Blood sugar

Question 13

Treatment of Otomycosis

______________ of fungal mass

_________ of the canal with 2% __________or 1% __________ ____________________ .
Keep ear (dry or wet?).
Treatment of ______________, eg DM.

Answer 13

Aural Washout

Painting ;salicylic acid ; Gentian Violet

antifungal ear drops .

dry ; underlying

Question 14

Malignant Otitis Externa

(Mild or Severe?) and ___________ infection of the ______________________, involving the ___________ and adjacent ___________ commonly seen in ___________ patient
or ___________ patient.

Answer 14

Severe ; aggressive

external auditory meatus,

temporal bone ; soft tissue

immunocompromised ; diabetic

Question 15

Malignant Otitis Externa

(Mild or Severe?) and ___________ infection of the ______________________, involving the ___________ and adjacent ___________ commonly seen in ___________ patient
or ___________ patient.

Answer 15

Severe ; aggressive

external auditory meatus,

temporal bone ; soft tissue

immunocompromised ; diabetic

Question 16

ETIOLOGICAL AGENT of Malignant Otitis Externa

_____________________

Answer 16

Pseudomonas aeruginosa

Question 17

Presidposing factors to Malignant Otitis Externa
_____________ above ____ years of age. _____________ patients
_____________
_____________ in children
Patient on prolonged _____________

Answer 17

Uncontrolled DM ; 55

Immunocompromised; Malnutrition

Anemia ;steroids.

Question 18

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.

Answer 18

cellulitis ; ; rapidly ; tissue

suture lines ; skull base.

vascular channels ; osteitis

9th 10th, 11th & 12th

Contralateral ;petrous apex ; basi-sphenoid

Question 19

Clinical features of malignant otitis externa

_______ (severe)

Discharge – __________in initial stage, __________ and __________ later.

Hearing loss.
_______________.
Tenderness of the __________ or pulling of the __________.

Answer 19

Pain ; mucopurulent

purulent ; blood stained

Facial nerve palsy.

EAC pinna ; mastoids.

Question 20

OTOSCOPIC EXAMINATION in malignant otitis externa

External auditory canal is (narrow or wide?) .
Granulation tissue in the ____________
TM is ________.
Sings of ________________ in late case.

Answer 20

narrow ; deep meatus

normal ; cranial nerve palsy

Question 21

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.

Answer 21

Ear swab

Isotope

Question 22

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 ___________.

Answer 22

Gentamycin ; Tobramycin

relapse ; Drainage

sub-periosteal abscess ;necrotic bone.

granulation tissue.