Otology Flashcards
Otitis Externa
Inflammation and infection process of the external auditory canal +/- auricle
Predisposing factors otitis externa
Heat
Humidity
Trauma
Exposure to water
Most common pathogen otitis externa
Pseudomonas aerugimosa and S. aureus
Otitis media Hx
Otalgia
Otorrhoea
Aural fullness
Pruritis
Tenderness
Hearing loss
Mangement otitis externa
- Abx drops (Sofradex, ciproxin)
- Earwick insertion to stent open EAC if there is occlusion (remove after 24hrs)
- Aural suctioning
- Analgesia
- May need surgical management if exostoses (surfers ear) is present
Acute otitis media
Inflammation and infection of the middle ear
Underlying pathogenesis of sicure otitis media
Pharyngotempanic (Eustachian) tube dysfunction
Usually preceded by a viral URTI
Acute otitis media
Otalgia
Fever
Hearing loss
Otorrhoea
Can have decreased appetite and concurrent URTI
Exam finding acute otitis media
Bludging TM with erythema can be seen
Acute otitis media management
- Reassurance with analgesia and watchful waiting (<6m or not improving within 24hrs, Abx is first line)
- Abx (Amoxicillin)
- Analgesia
Otitis media with effusion
Aka glue ear
Inflammation of middle air space with the presence of effusion
Risk factors for OME
Parental smoking
Abscence of breast feeding
Adenoid hypertrophy
Day care attendance
Hx OME
Often asymptomatic
Decreased hearing
Poor sleep
Otoscopy findings OME
Dull grey or yellowish immobile TM
If TM clear air-fluid levels can be seen
Mangement OME
High risk - ENT review (grommets)
Low risk - watchful waiting, if still resent after 3 months - ENT referral
Otitis externa complications
Malignant otitis externa (skullbase osteomyelitis)
Acute otitis media complications
TM perforation
Mastoiditis
Facial nerve paresis
Labyrinthitis
Intracranial complications (meningitis, abscess, sigmoid sinus thrombosis)
Otitis media with effusion complications
Conductive hearing loss (developmental impact)
Speech delay
Atelectasis/TM retraction
Cholesteatoma (retracted membrane causes distraction of squamous epithelium movement)
What is a cholesteatoma
A destructive lesion of the skull base and middle ear formed by trapped squamous epithelium
Trapped squamous epithelium forms a sac with keratin debris
Hx cholesteatoma
Persistent or recurrent purulent otorrhoea
Hearing loss
Tinnitus
Rarely: vertigo, ataxia, facial nerve paresis
Ix for cholesteatoma
Ct scam
Adiometry
MRI
Mangement for cholesteatoma
Surgery - mastoidectomy
Microscopic removal of debris
Keep ear out of water
Tropical Abx
cholesteatoma complications
Bone erosion
Sensorineurol hearing loss
Facial nerve injury
Infection (mastoiditis, intracranial abscess, sigmoid sinus thrombosis, meningitis)
What is presbycusis?
Otherwise unexplained SNHL in the elderly - usually bi, lateral, ynand symmetrical
