Otitis externa

Question 1

What are the referral conditions for otitis externa?

Answer 1

• Generalised inflammation of the pinna
• Impaired hearing in children not associated with ear wax
• Mucopurulent discharge and systemically unwell; otitis media
• Slow-growing growths on the pinna in elderly people; malignancy

Question 2

How does otitis externa typically present?

Answer 2

• Itching and irritation which may become intense,provoking patient to scratch
• pain (chewing and manipulation of pinna exacerbate pain)
• may be discharge but will NOT be mucopurulent
• skin of EAM can become oedematous (leading to conductive hearing loss

Question 3

What are the dose, directions, maximum period of use and age limit for earcalm spray?

Answer 3

• One spray (60mg) into affected ear at least three times a day.
• treatment continued until 2 days after symptoms improved
• if symptoms do not improve within 48 hours, stop treatment and see doctor
• don’t use for more than 7 days
• > 12 years old

Question 4

Give some factors that may increase your odds of developing otitis externa?

Answer 4

• aged 10 - 14
  -hot and humid climates +
  in western society episodes increase in summer months
  -swimmers 5 times more likely
  -women > men

Question 5

Differentiate Otitis externa and dermatitis?

Answer 5

Dermatitis presents with itch but no pain or discharge, dermatitis will show skin involvement elsewhere

Question 6

Differentiate Otitis externa and acute otitis media

Answer 6

• Acute otitis media will present quite early (3-6)
• Fever and loss of appetite
• Red bulging tympanic membrane
• self limiting mostly (3 day resolution)