Otits Externa (OE) Flashcards
What is otitis externa
Inflammation and infection of auricle and external auditory Canal
1. Acute, diffuse, localized
2. Swimmers ear
What are the common organisms causing otitis externa
- Pseudomonas aeruginosa MC
- Proteus fungi (Aspergillus or Candida)
What is otitis externa due to
Repeated exposure to water
*removes cerumen and dries canal
What does drying of the ear canal lead to
Increased pruritus eventual skin maceraiton and breakdown, infection invasion
What is the perfect environment for OE to occur
- No cerumen
- Water
- Pruritus
- Repeated local trauma
What are the signs of otitis externa
History of recent water exposure or mechanical trauma
1. Cleaning ear canal with cotton swab
2. Otalgia, otorrhea (purulent in nature)
3. Muffled hearing
What will be found on PE
Pain with manipulation of the auricle and tragus
Canal will have
1. Erythema
2. Edema
3. Occluded due to purulent exudate/debris
4. Unable to visualize TM
5. Periauricular lympahdenopathy
What is the treatment for OE
- Treat pain (Tylenol, NSAIDS)
- Remove debris from canal
- Topical medications to control edema and infection
- Protect the canal
*avoid water
What is an ear wick
Used to penetrate depth of ear canal with topical ATB suspension
1. Neomycin
2. Polymyxin B
4. Cipro + corticosteroid
How to use an ear wick
- Wick is place into ear canal
- Topical ATB is applied 5 drops 3-4 times daily
Can PO ATB be used to treat OE
Not indicated unless appears as cellulitis of periauricular tissue
For how long should you continue to ear wick drops?
Until symptoms resolve at least 48 hours
How to keep ears dry
- Turn head to side
- Pull on earlobe to facilitate exit of water
- Vinegar, isopropyl alcohol to rinse ear canals
What is malignant OE or necrotizing OE
Can lead to osteomyelitis extension into mastoid and temporal bone
*life threatening
Who is at risk for malignant OE
- DM
- Immunocompromised
- Elderly
