Otitis media and externa Flashcards
What things can precipitate otitis externa?
Swimming (wet ears)
Eczema/ dry ears
What is necrotising otitis externa?
Infection that has spread from the skin to the bone. Causes severe pain that will be waking them up
Frequent in diabetics and immunocompromised
It can spread into the brain and cause death
What is a Cholesteatoma?
An abnormal collection of dead skin cells deep inside the ear
What are the different types of otitis media?
Mucosal disease:
- Acute disease
- Otitis media with effusion (glue ear)
- Chronic suppurative otitis media
Squamous disease:
- Tympanic membrane retraction
- Cholesteatoma
When is otitis media most common?
Children: most common bacterial infection (2/3 by 5yrs)
More common in deprived areas
Which bacteria are most commonly causing ear disease?
- Streptococcus pneumoniae(pneumococcus)
- Non-typeable Haemophilus influenza (NTHi)
- Moraxella catarrhalis
What are some signs and symptoms of otitis media?
Ear pain
Fever
Red tympanic membrane
Often non specific
How is otitis media treated?
Analgesia most important
- Antibiotics not often used because the infection may resolve by itself
- No effect of antibiotics for 24 hours
- Given only to severe disease
What are some complications of otitis media?
- Mastoiditis (pinna is pushed forward and area is red) Treated with IV antibiotics
- Intracranial infection (presents with headache and fever)
What is the definition of chronic otitis media with effusion?
Infection for > 3months
Treated if there is associated hearing disability
What is chronic suppurative otitis media?
AKA chronic otitis media
- Causes perforation of the tympanic membrane
- Intermittent or persistent ear discharge
- Often painless because there is no stretching of tympanic membrane as it’s gone
- Hearing loss from perforation and from associated ossicular erosion
How is chronic otitis media treated?
Ciprofloxacin (antibiotic)
And tissue spears to absorb the pus so that antibiotics go straight to the area needed
What is Myringoplasty?
Surgery to close the hole in the eardrum
How is tympanic retraction treated?
Treatment for recurrent infection or associated hearing loss
What are some complications of a cholesteatoma?
Hearing loss
Facial weakness
Meningitis
Temporal lobe abscess
Causes erosion in the ear canal, polyps and degeneration of the membranes