Outer & Middle Ear Flashcards
How is Auricular Haematoma treated?
Incision and drainage.
A pressure dressing to prevent reaccumulation of a Haematoma
Antibiotic is to prevent infection
What is the complication of Auricular Haematoma?
Cauliflower Ear. In which there is necrosis of the cartilage of the auricle, leading to deformity
How is foreign body in the outer ear managed?
It needs to be removed. There is varying urgency in these to remove foreign body from the outer ear. A button battery foreign body needs to be removed within hours. Organic foreign body needs to be removed with in days. Inorganic foreign body needs to be removed within a few weeks.
Define Otitis Externa
Inflammation of external auditory meatus
How is Otitis Externa managed?
The most appropriate management is topical. Give them ear drops that contain antibiotics to address any infection. And equally important, steroids to address any inflammation. If the ear is full of discharged, it is best to use suction under microscope.
How to prevent Otitis Externa?
No water or cotton buds
Define “Malignant” Otitis Externa
Osteomyelitis of temporal bone
What is the presentation of Malignant Otitis Externa ?
Severe pain in elderly diabetic
Granulation in external auditory meatus
You may get cranial nerve palsies
What is the management of Malignant Otitis Externa ?
Long term antibiotics for weeks or months
What is Otitis Media with effusion? Aka glue ear
Sterile fluid within the middle ear. It is called glue ear because the middle ear secretes mucus and the often the fluid has a gluey consistency
What is the presentation of Otitis Media with Effusion
Hearing loss
Speech delay
What is the management for Otitis Media with effusion
Observation for 3 months
Otovent - if the condition gets worse
Grommet - if the condition gets worse
Note that the majority of glue ear in children will get better by themselves without any intervention.
What is Acute Superlative Otitis Media?
Typically a problem in children. Pus in the middle ear.
What is the presentation of Acute Suppurative Otitis Media?
Classically, child will present with increasing pain in the ear followed by discharge when the eardrums bursts.
Otalgia
Otorrhoea
What is the management for Acute Suppurative Otitis Media?
Observation. We should hold off antibiotics for a few days as the majority don’t need them.
What is Tympanosclerosis?
Calcification in tympanic membrane in the middle ear
What is the presentation of Tympanosclerosis?
Usually asymptomatic.
White patches in the tympanic membrane.
What is the management for Tympanosclerosis?
Usually none
What is the pathology of Chronic Suppurative Otitis Media?
Perforated tympanic membrane or cholesteatoma
What are the complications of Chronic Suppurative Otitis Media?
It can spread into the inner ear and cause complete hearing loss.
It can affect the facial nerve, which you know that it runs through the middle ear and cause facial palsy
It can spread upwards into the brain and cause meningitis or brain abscess
What are the causes of Perforation of tympanic membrane?
Infection
Trauma
Grommet
What is the presentation of Perforation of tympanic membrane?
Recurrent infections
Hearing loss
What is the management of perforation of tympanic membrane?
Water precautions
Myringoplasty
What is the second form of chronic Suppurative otitis media?
This is a more serious one called Cholestetoma
What is the pathology of Cholesteatoma?
Eustachian tube dysfunction
Impaired skin migration
What is the presentation of Cholesteatoma?
Persistent offensive otorrohoea
What is the management of Cholesteatoma?
Mastoidectomy
What is the pathology of Otosclerosis?
Fixation of stapes 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 neurone Facial palsy (forehead involved)
What is the differential diagnosis of Facial Nerve Palsy?
Intratemporal eg Cholesteatoma
Extratemporal eg parotid tumour
Idiopathic = Bell’s Palsy
What is the management of Facial nerve Palsy?
Treat the underlying causes if possible
Steroids
Eye care
