Outer Ear Flashcards
What is otitis externa?
Inflammation of the outer ear caused by bacterial or fungal infection
What bacteria are associated with otitis externa?
Pseudomonas aeruginosa
Staphylococcus aureus
What fungi are associated with otitis externa?
Candida albicans
Aspergillus niger
What organism causes black lesions in otitis externa?
Aspergillus niger
How does otitis externa present?
Commonly in swimmers
Inflammed skin in outer ear
Itch
Discharge
Conductive hearing loss
What is the mainstay of otitis externa management?
Ear cleaning (topical aural toilet)?
What treatments are there for persistent
- bacterial
- fungal
otitis externa?
- Gentamicin drops
2. Topical cotrimoxazole
What is a risk factor for otitis externa?
Swimming
What is malignant otitis externa?
Extension of otitis externa infection into mastoid/temporal bones
What organism most commonly causes malignant otitis externa?
Pseudomonas aeriginosa
How does malignant externa present?
Pain worse than clinical picture suggests
Exposed bone in ear canal
Granulation tissue at bone-cartilage junction
What does untreated malignant otitis externa progress to?
Infection spreads into skull and meninges causing fatal meningitis
What are the two types of temporal bone fracture and how do they differ?
Longitudinal and transverse
Longitudinal fracture lines are parallel to petrous part of the temporal bone
Transverse fractures lines are perpendicular to petrous part of temporal bone
How do temporal bone fractures present?
History of blunt trauma
Battle sign (pre-auricular bruising)
Hearing loss
How do longitudinal temporal bone fractures present?
Battle sign
Lateral blows
Conductive deafness
Bleeding
CSF leak
How do transverse temporal bone fractures present?
Battle sign
Frontal blow
Sensorineural deafness
Vertigo (CN VIII damage) Facial drooping (CN VII damage)
What is a pinna haematoma?
Blood collection within auricle caused by traumatic separation of perichondrium form cartilage
How do pinna heamatoma present?
Tender auricular swelling after ear trauma
What are the options for pinna haematoma management?
Needle aspiration
Incision and drainage
Pressure draining
How do manage ear lacterations?
Transport loose pinna pieces in ice wrapped in gauze
Debride any damaged/infected tissue
Suture pinna together under local anaesthetic
5-day-course of antibiotics if from a bite or looking nasty
In what injury mechanism for ear lacerations are debridement ant antibiotics particularly important?
Dog bites
What is a complication of untreated pinna haematoma?
Cauliflower ear
What type of hearing loss do you get in transverse/longitudinal temporal bone fractures and why?
Transverse: sensorineural (damage to CN VIII)
Longitudinal: conductive (haemotympanum or ossicular chain disruption)
