Otitis Externa

Question 1

What is a papoose board used for?

Answer 1

It is a restraint used for child when examining the ear safely.
Toddlers between age 1-3 are the most difficult to examine the ears.

Question 2

What are common risk factors for otitis externa?

Answer 2

swimming
hot, humid climates
seborrhea (cradle cap) or eczema
trauma to external ear canal (q tip, foreign objects)
not drying ears after showering or swimming
hearing aid use

Question 3

T/F Chlorine in pools prevents otitis externa

Answer 3

False

chlorine kills normal flora which promotes pathogen growth

Question 4

What are signs and symptoms with otitis externa

Answer 4

pain especially when pulling on pinna (otalgia)
edema and redness in the external auditory canal
itching in the external auditory canal
otorrhea/purulent discharge in external canal
normal TM
itching and irritation which progresses to pain
pressure and fullness in ear (decreased hearing)

chronic: dry, flaky, thinning canal

Question 5

What are common pathogens with otitis external

Answer 5

Fungal: Aspergillus (most common) black lesion on TM
Bacterial: Pseudomonas (most common)

Question 6

What is management of otitis externa?

Answer 6

avoid swimming during week of treatment
thorough cleansing of ear with saline or burrows solutioin
Antibiotic ear drops with or without steroid
Cipro + hydrocortisone (Cipro HC otic): DO NOT use if the TM is perforated

*** fluoroquinolone ear drops are first line treatment