Outer and Middle Ear Flashcards
What is auricular haematoma?
Collection of blood below skin of outer ear
Typically due to blunt trauma in sports
What is the management for auricular haematoma?
Incision and Drainage
Pressure dressings
Antibiotics to prevent infection
What is the complication of auricular haematoma?
Cauliflower ear - deformity of ear after blunt force trauma and formation of fibrous tissue
How is foreign body in ear managed?
Removal
Describe the urgency of foreign body in ear
Urgent if button battery as corrosive
Organic can be a couple days
Inorganic can be a couple weeks
What is otitis externa?
Inflammation of skin and subdermal of external ear canal (External auditory meatus)
What is the management for otitis externa?
Antibiotics/ steroids eardrops (topical)
Maybe need suction under microscope
How does otitis externa present?
Pain, discharge, itching, and possible hearing loss
What is the prevention for otitis externa?
No water or cotton buds
What is ‘malignant’ otitis externa?
Not neoplastic but can spread to skull base
Osteomyelitis of temporal bone
What is the presentation of ‘malignant’ otitis externa?
Severe pain in elderly diabetic
Granulations in external auditory meatus
Mabye cranial nerve palsies
What is the management of ‘malignant’ otitis externa?
Antibiotics for weeks or months
What is otitis media with effusion?
Sterile fluid in the middle ear due to low pressure as Eustachian tube isn’t functioning correct so lining secretes mucus - ‘glue ear’
How does otitis media with effusion present?
Hearing loss and then could lead to speech delay
What is the management of otitis media with effusion?
Observation for 3 months
Otovent - balloon
Grommets - plastic tube
What is acute suppurative otitis media?
Pus and inflammation in the middle ear
Usually in children
What is the presentation of acute suppurative otitis media?
Otalgia - ear pain
Possible Otorrhea - discharge from the ear
What is the management of acute suppurative otitis media?
Observation and possible antibiotics
What is tympanosclerosis?
Calcification in tympanic membrane and possible middle ear
White patches on appearance
Can be consequence of previous infection or grommets
What is the presentation of tympanosclerosis?
Usually asymptomatic
What is the management for tympanosclerosis?
Usually none
What is the pathology for chronic suppurative otitis media?
Perforated tympanic membrane
Cholesteatoma (skin in middle ear and maybe mastoid bone)
What are some complication of chronic suppurative otitis media?
Dead ear - hearing loss if spread to inner ear
Facial palsy
Meningitis
Brain abscess
What are some causes of perforated tympanic membrane?
Infection, trauma, and grommets
What is the presentation of perforation of tympanic membrane?
Recurrent infections and hearing loss
What is the management for perforated tympanic membrane?
Water precautions
Possible myringoplasty - repair hole in eardrum if trouble hearing, recurrent, or can’t avoid water
What is cholesteatoma?
Abnormal collection of skin cells deep in ear
Can be caused by Eustachian tube dysfunction or impaired skin migration (pocket of dead skin)
What is the presentation of cholesteatoma?
Persistent offensive otorrhea - discharge
Needs referral to EMT
What is the management for cholesteatoma?
Mastoidectomy - removal of cholesteatoma
What is otosclerosis?
Fixation of staples (bone of middle ear) by extra bone
What is the presentation of otosclerosis?
Conductive hearing loss
Normal tympanic membrane
What is the management of otosclerosis?
Hearing aid or stapedectomy
What are the clinical features of facial nerve palsy?
Lower motor neuron facial palsy - forehead involved
What are the differential diagnosis for facial nerve palsy?
Intratemporal - cholesteatoma
Extratemporal - parotid tumour
Idiopathic - Bell’s palsy
What is the management for facial nerve palsy?
Treat underlying cause if possible
Steroids
Eye care
