Otitis Externa

Question 1

RF

Answer 1

Diabetic, swimming, XS earwax, skin problems.

Question 2

Presentation

Answer 2

Painful and itchy discharge from external ear.
Hearing loss
Fungal or bacterial

Question 3

When is Abx incdicated?

Answer 3

Furunculosis
Fever
Patient is immunocompromised i.e. malignancy, DM,

Question 4

Management

Answer 4

Topical Acetic acid drops
If indicated, Abx i.e neomycin (as ear drops) or oral fluclox. If allergy, clarithromycin. 7 days.
If resistant swab discharge.
Microsuction, wick for drainage

Question 5

Complications

Answer 5

Sepsis, facial nerve palsy, malignant otitis externa

necrotising OE.

Question 6

What is malignant otitis external

Answer 6

Severe infection in ear canal which spreads to skull base, usually occurring in diabetic patients.

Fever above 39, facial nerve palsy, granulation tissue exposing bone in ear canal.