otorrhea Flashcards
what does the term otorrhea refer to ?
ear discharge
what are the types of ear discharge ?
wax (physiological)
pus or mucopus
blood
CSF
what points are important to cover when analysing otorrhea ?
duration
intermittent or persistent
offensive smelling (cholesteatoma)
earache
fever
hearing loss
history of head trauma (CSF)
FB in children
what is the presentation of otitis externa ?
scanty thin watery discharge
meatal narrowing
itching ( especially if due to fungal infection)
tenderness on pulling of the tragus or the auricle
when should malignant otitis externa be suspected ?
if treatment has been given for otitis externa but there is no response for more than 2 weeks
patient is immunocompromised e.g diabetic
what is the presentation of acute otitis media ?
usually presenting in children
fever
vomiting
otalgia
hearing loss
fever and symptoms of pain decrease once there is a release of the discharge from the middle ear
mucopurulent ear discharge
what is the presentation of cholesteatoma ?
purulent offensive discharge
characteristic of cholesteatoma
retraction pocket either posterosuperior or attic
keratinn debris in pocket
adjacent bony erosions
granulations in the mucosa which bleed upon contact
perforated TM if acquired
when do we suspect CSF otorrhoea ?
watery clear discharge
history of head trauma
persistent watery discharge following myringoplasty
how does CSF otorrhea happen ?
history of head trauma usually due to fracture of tegmen
broadly what are the causes of bloody otorrhoea ?
trauma
tumors
what kind of trauma can cause bloody otorrhea ?
lacerations of the external auditory canal
traumatic rupture of the tympanic membrane
fracture of the skull base
what tumors can cause bloody otorrhea ?
malignant tumors
glomus tumors
where do glomus tumors originate from ?
chief cells of the paraganglia
where are the sites in which glomus tumors can present/ exist ?
- carotid body tumor
- jugular bulb tumor
- middle ear ( glomus tympanicum)
what is the function of a glomus body ?
thermoregulatory function
what is thee presentation of a glomus tumor of the middle ear ?
conductive hearing loss
pulsatile tinnitus
ear fullness
bloody otorrhea
bruit
presence of a middle ear mass
what is the commonest ear discharge ?
wax
which nerve is associated with glomus body tumors of the middle eear ?
jacobsons nerve
what is the jacobson’s nerve ?
the tympanic branch of the glossopharyngeal nerve
what is the association of a glomus tumor in the jugular bulb to the ear ?
glomus jugulare are found along the jugular bulb and they involve the skull base and may extend in the middle ear
