Module 2 otitis externa

Question 1

otitis externa

Answer 1

cellulitis of the external auditory canal
- may extend to the auricle (pinna)
- “swimmer’s ear”
- seen more often in warmer months in places of high humidity

Question 2

otitis externa can progress to

Answer 2

malignant/necrotizing otitis externa
- seen with immunocompromised or pt with co-morbidities like DM

Question 3

Patho of otitis externa

Answer 3

removal of protective cerumen with damage to skin
- vigorous cleaning
- maceration of skin from accumulation of moisture
- alterations to the tissues from headphones/ear plugs

Question 4

common causative organism for otitis externa

Answer 4

pseudomonas aeruginosa
staphylococcus aureus

Question 5

otitis externa s/s

Answer 5

pain in ear and auricle developed over 48 hours or less
fullness
itching
possible drainage and hearing loss

Question 6

otitis externa physical exam

Answer 6

• pain and tenderness on palpation of tragus and repositioning of auricle
• canal may be erythematous and edematous
• filled with debris and sloughed tissue
• TM may be erythematous or poorly visualized
• may extend to external ear with enlargement of periauricular lymph nodes

Question 7

chronic otitis externa physical exam

Answer 7

• canal is dry
• cerumen may be absent
• excoriation secondary to use of objects inserted to relieve the itching
• Discharge may be present
• canal may be narrowed secondary to thickened canal walls

Question 8

otitis externa complications

Answer 8

malignant otitis externa

Question 9

malignant otitis externa

Answer 9

invasive osteolyelitis of the ear
- bacterial infection extends into cartilage and bone
- caused by P. aeruginosa
Commonly seen in:
- older
- DM
- immunocompromised

Question 10

malignant otitis externa s/s

Answer 10

severe pain
necrotic ulcerations
fever
facial paralysis and other cranial nerve abnormalities may occur

Question 11

TM perforation

Answer 11

opening in the otherwise intact membrane

Question 12

TM perforation and hearing loss

Answer 12

can result in conductive hearing loss

Question 13

TM perforation causes

Answer 13

traumatic
infectious
neoplastic
lacerated or perforated by objects in the external canal
barotrauma
physical trauma
blast injury
fracture of the temporal skull
pressure and inflammation of OM

Question 14

perforation s/s

Answer 14

hearing loss
sensation of fullness or popping
tinnitus
vertigo
r/t trauma: bleeding, hearing loss, pain
r/t infection: drainage or bleeding

Question 15

TM perforation management

Answer 15

heal quickly and spontaneously unless infected or very large
- antibiotic drops or systemic antibiotics