otology (week 1) Flashcards
common presenting symptoms with otological problems?
hearing loss, tinnitus, discharge, otalgia (ear pain), dizziness (imbalance/vertigo)
facial weakness (facial nerve palsy), headaches, skin conditions, and alergies.
why do we need wax?
antibacterial properties
ask them to use olive oil to clear wax or use sodium bicarbonate drops (remember john when he had ear wax build up)
sometimes need to use a microsuction
patient comes back from holiday from spain, been swimming in the sea and has painful right ear with discharge. presentation and treatment for otitis externa?
itchy ears, lots of discharge
topical antibiotics - Sofradex, gentisone HC ear drops or otomise spray
if eardrum is perforated or not visible use cilodex
don’t use aminoglycosides
a patient has otitis externa but has not been following treatment and then causes his ear to swell, discharge cant leave and he is in a lot of pain. what will we have to do?
use a pop wick (tampon that fits in ear which is laced with antibiotic drops, should stop it collapsing and after 3 days return to normal treatment
what do we do for cellulitis of the pinna (result of severe form of otitis externa)?
admit to hospital
use IV and topical antibiotics, and treat underlying diabetes if any
what are some of the causes of fungal otitis externa?
consistently wet ears (maybe swimming on holiday), frequent use of antibiotics (so fungus takes over as bacteria is suppressed), mastoid cavity which is wet and keeps discharging.
treat with clotrimazole or nystatin ear drops for 2 weeks, keep the ears dry, and possibly micro suction.
what is malignant otitis externa?
infection spreads from ear canal to petrous bone
seen in diabetics (check blood sugars) or immunocompromised patients
usually caused by pseudomonas, treat with ciprofloxacin
URGENT REFERRAL TO ENT
treatment for otitis media with effusion?
insert a grommet (to drain fluid)
what is tympanosclerosis
thickening of the ear drum, usually due to a history of grommets. presents with white patches
