otology diseases and treatments Flashcards
when to treat build up of ear wax
mild ear pain and mild hearing loss
how to treat wax
first line ear drops olive/almond,
NAHCO3 drops from over the counter, 0.9 saline
If symptoms persist can be referred for syringe or microsuction
what tool scan be used to remove wax
wax hook, right angled hook, syringing and suction
what is important to consider with foreign objects in the ear
organic materials need to be removed immediately as they can cause otitis externa
otitis externa symptoms
ear ache, itchy ear and discharge
treatment for otitis externa
topical antibiotics/steroid drops (usually a antibiotic + corticosteroid like dexamethasone)
what topical drops are used to treat otitis externa
SOFRADEX, GENTISONE HC OR OTOMIZE SPRAY
what to do if there is a history of proliferated tampanic membrane
CILODEX (ciprofloxacin and dexamethasone) Aminoglycosides can cause sensorineural hearing loss
if the patient does not comply
inert a small tampon with the medication on it and remove in 3 days
if the patient still does not comply or continues to get the ear wet it can cause cellulitis
what to do if the patient presents with cellulitis
admit to hospital treat with iv and topical antibiotics
what are the most common organisms that cause otitis externa
pseudomonas
what are the most common organisms that cause fungus otitis
due to chronic wet ear
aspergillus niger and aspergillus fumigatus
how to treat fungus otitis
topical clotrimazole or nystatin for two weeks
what is Malignant/necrotizing otitis externa
Necrotizing (malignant) otitis externa (NOE) is a severe infection that affects the external auditory canal, skull base, and temporal bone
what are featured of Malignant/necrotizing otitis externa
Common in diabetics and immunocompromised
Longer than 6 weeks
Granulation tissue
Patient can present with facial nerve palsy
Severe ear pain that may worsen over time.
Foul-smelling ear discharge.
Swelling and redness in the ear canal.
Hearing loss.
Fever and systemic symptoms in severe cases.
what is a good distinctive symptom of Malignant/necrotizing otitis externa
Foul-smelling ear discharge
treatment for Malignant/necrotizing otitis externa
take a swab to identify organisms
treat with topical and iv ciprofloxin if resistant use tazocin
refer to ENT to get a CT of temporal bone
usually uncontrolled diabetes so manage the blood sugar levels
how to treat acute otitis media
amoxicillin
what is glue ear
glue ear is otitis media with effusion
how to treat glue ear
typically gets better on its own in 4-6 weeks
see patients after 3 months
if they still have glue ear
first line treatment otovent
can use inert grommet if hearing loss is resistant
what is otovent
otovent is a small balloon which the child blows up using their nose. Otovent equalises the pressure and relieves the symptoms in the middle ear. The act of blowing up the balloon helps to open up the Eustachian tube, making it easier for fluid to drain from the middle ear.
what will the audiogram and tympanometry show if there is glue ear
low frequency conductive hearing loss
flat line tympanometry
what is Tympanosclerosis and does it need treatment
calcification in tympanic membrane no treatment is usually needed
What is Cholesteatoma
skin trapped in the middle ear or mastoid bone it can release enzymes that digest bone
