Outer and Middle ear Flashcards
what is auricular haematoma?
blood accumulates in the layer between the perichondrium and cartilage
what typically causes an auricular haematoma?
trauma to the ear
how do you manage a auricular haematoma?
incision and drainage
pressure dressing
antibiotics
what is a complication of auricular haematoma?
cauliflower ear
what are the management options for a foreign body in the ear?
removal
how quickly would a button battery, organic and inorganic material need to be removed from the ear?
button battery > organic > inorganic
button battery - hours
organic - days
inorganic - weeks
what is otitis externa?
inflammation of external auditory meatus
how is otitis media treated?
antibiotic/steroid ear drops
+/- suction under microscope
what are preventative measures for otitis externa?
no water or cotton buds
what is malignant otitis externa?
osteomyelitis of temporal bone
how would malignant otitis externa present?
severe pain in elderly diabetic
granulations in external auditory meatus
+/- cranial nerve palsies
how is malignant otitis externa managed?
long term antibiotics for a few weeks/months - organism being treated is usually pseudomonas
what is otitis media with effusion?
glue ear
sterile fluid in middle ear
how does otitis media present?
hearing loss
speech delay
how is otitis media managed?
observation for three months - usually clear up on own with children
Otovent balloon - child blows up balloon through nose
Grommet - plastic tube in ear drum allowing ventilation
what is the definition of acute suppurative otitis media?
pus in the middle ear
how does acute suppurative otitis media present?
otalgia +/- otorrhoea
what is otalgia +/- otorrhoea?
Otalgia is ear pain and breaks down into two categories of primary otalgia and secondary otalgia. Primary otalgia is pain coming directly from the ear where secondary otalgia is referred pain from somewhere outside the ear.
how is acute suppurative otitis media managed?
observation
+/- antibiotics [hold off for a few days, majority not required]
what is tympanosclerosis?
calcification in tympanic membrane +/- middle ear
how does tympanosclerosis present?
usually asymptomatic
white patches on tympanic membrane
how is tympanosclerosis managed?
usually none
what is chronic suppurative otitis media?
Chronic suppurative otitis media, also known as chronic otitis media, is a stage of ear disease in which there is an on-going chronic infection of the middle ear without an intact tympanic membrane. This disease is a chronic inflammation of the middle ear and mastoid cavity
what is chronic suppurative otitis media caused by?
perforated tympanic membrane
or
cholesteatoma
(skin in middle ear +/- mastoid bone)
what are complications of chronic suppurative otitis media?
“dead ear”
facial palsy
meningitis
brain abscess
what are causes of a perforated tympanic membrane?
infection
trauma
grommet
how does a perforated tympanic membrane present?
recurrent infections
hearing loss
how is a perforated tympanic membrane treated?
water precautions
+/- myringoplasty
what is cholesteatoma?
A cholesteatoma is an abnormal collection of skin cells deep inside your ear.
what are causes of choleastoma?
Eustachian tube dysfunction
impaired skin migration
how does cholesteatoma present?
persistent offensive otorrohoea - red flag symptom should trigger refferal to ent
how is cholesteatoma treated?
mastoidectomy
what is otosclerosis?
abnormal bone growth in the middle ear that causes hearing loss.
what is the presentation of otosclerosis?
conductive hearing loss
normal tympanic membrane
what is the pathology of otosclerosis?
fixation of stapes by extra bone
how is otosclerosis managed?
hearing aid
or
stapedectomy
what is facial nerve palsy?
Facial nerve paralysis is an inability to move the muscles that control smiling, blinking, and other facial movements. This condition can affect a person’s ability to convey emotion. Most of the time, facial paralysis is limited to one side of the face.
what are the clinical features of facial nerve palsy?
lower motor neuron facial palsy
(forehead involved)
what are differential diagnosis for facial nerve palsy?
intratemporal eg cholesteatoma
extratemporal eg parotid tumour
idiopathic = Bell’s palsy
what is the management of facial nerve palsy?
treat underlying cause (if possible)
steroids
eye care
